Cardiomegaly, or enlarged heart, is a condition in which the heart becomes larger than its normal size and affects its regular function of pumping blood to various organs.
“It [enlarged heart] can be a sign of an underlying health condition,” says Dr. Vanita Arora, Senior consultant, Cardiac electrophysiologist and Interventional cardiologist, Indraprastha Apollo Hospital, New Delhi.
“When the heart chambers are dilated, because of conditions like congenital heart problems, it leads to an enlarged heart,” says Dr. Brijesh Srivastava, Consultant Interventional Cardiologist, Rhythm Heart Clinic, Bhopal.
An enlarged heart causes breathlessness, lung congestion, weight gain, leg swelling, reduced appetite, palpitation, fatigue on minimal exertion, lethargy, decreased urine output and reduced exercise or walking capacity.
What could lead to an enlarged heart?
There are several factors that could lead to enlargement of your heart.
- Coronary artery disease (CAD)
Dr Arora says that the most common cause of an enlarged heart is coronary heart disease which could also cause heart attack. Dr Srivastava says that the heart will have to work harder to pump blood if there are blockages making the heart become more dilated and enlarged.
Coronary artery disease causes reduced blood flow to the heart muscle due to blocked or narrowed arteries. People who have survived a heart attack are also at risk of developing an enlarged heart.
Dr. Srivastava says that muscles affected in a heart attack get damaged due to disrupted blood flow after a heart attack.
“So, it leads to the thinning of that muscle and enlargement of that chamber,” he adds.
- Cardiomyopathy
Cardiomyopathy is a group of conditions that cause the heart muscle to become rigid and thick. This makes it harder for the heart to pump blood causing the heart to become enlarged in size.
Dilated cardiomyopathy (enlargement of one or both ventricles in the heart) is a genetic condition that is present since birth. “The person remains asymptomatic for a long time. But when they develop blood pressure or any rhythm disturbances or acute stress that can lead to heart failure, then through ECG (echocardiography) we can see that the person has dilated cardiomyopathy,” says Dr. Srivastava.
- Athlete’s heart
Some athletes may have a slightly enlarged heart due to exercise. The heart muscles become thicker due to regular workouts. In most cases it is considered as a benign condition.
“They have certain additional chamber dilations, but their pump function is normal. The efficiency is as good as a normal heart,” says Dr. Srivastava.
- Valvular heart disease
“Whenever the valves are obstructed, or there is a leakage in the valves, it leads to additional pressure on the heart (increased pressure or volume of blood), causing heart enlargement,” says Dr. Srivastava.
- Syndrome X (metabolic Syndrome)
Syndrome X, a metabolic syndrome is another condition which causes heart size to increase. “Metabolic syndrome is the combination of diabetes, hypertension, and obesity, along with dilatation (enlargement) of the heart,” says Dr. Arora.
Being overweight or obese can put extra strain on the heart, leading to an enlargement of the heart over time. Diabetes and hypertension can also cause the heart to enlarge. Consistently high blood pressure can cause the heart to work harder, leading to an enlarged heart.
“Hypertension and diabetes are also risk factors for coronary artery disease which causes an enlarged heart,” says Dr. Srivastava.
- Cardiac shunt
Cardiac shunt is the abnormal or irregular blood flow in the chambers of the heart.
“Shunt is the crossover of the blood from one chamber to another which is not physiological or biological. It leads to additional workload on the heart causing the dilation of chambers. This leads to an enlarged heart,” says Dr. Srivastava.
Dr. Arora adds that other causes of an enlarged heart could be viral infections, mainly Hepatitis B virus causing myocarditis i.e., the swelling of the heart.
Dr. Srivastava explains that, enlarged heart is usually associated with heart failure. People with enlarged hearts with weak pump function are prone to have a sudden cardiac arrest or sudden cardiac death.
Preventing enlargement of heart
Prevention of an enlarged heart depends on the condition that caused it. For instance, if it is because of cardiomyopathy, you cannot reverse it.
However experts point out that it could be managed effectively by addressing and treating the underlying cardiac condition responsible for it.
Doctors point out that you should control the risk factors such as diabetes, hypertension, weight and cholesterol levels. One should quit smoking, lower alcohol consumption, exercise regularly to lower cholesterol, improve blood circulation and ensure overall better cardiac health.
Takeaway
Enlarged heart is often caused by the dilation of cardiac muscles due to various underlying heart conditions including coronary heart diseases. It affects the functioning of the heart and if left untreated could develop into life threatening cardiac complications. Heart attack survivors are also at higher risk of enlarged heart. Experts suggest timely medical intervention and lifestyle modifications to improve overall cardiac health to manage this condition.
