Enlarged heart

Diagnosis

To assess whether an individual has an enlarged heart (cardiomegaly), a doctor typically follows a diagnostic process that involves:

• Blood tests. Blood testing may be used to confirm or rule out medical problems that could result in enlarged hearts. Blood tests to assess the levels of chemicals in the blood caused by heart muscle injury may be performed if an enlarged heart coexists with chest pain or other indicators of a heart attack.
• Chest X-ray. An X-ray of the chest can help reveal the health of the heart and lungs. In most cases, additional testing are required to ascertain whether an X-ray-detected heart enlargement is true and to identify its etiology.
• Electrocardiogram (ECG or EKG). The electrical activity of the heart is measured by this rapid and painless examination. Electrodes are applied to the arms, legs, and chest in the form of sticky patches. The electrodes are connected by wires to a computer, which shows the test findings. If the heartbeat is excessively rapid or too slow, an electrocardiogram (ECG) can demonstrate this. Signal patterns can be examined by a medical professional for indications of hypertrophy, or thickening, of the heart muscle.
• Echocardiogram. The heart’s size, structure, and movement are visualized using sound waves in this noninvasive examination. The effectiveness of the heart’s function can be assessed by an echocardiography, which visualizes blood flow across the heart chambers.
• Exercise tests or stress tests. These tests often involve performing an exercise stress test using a treadmill or stationary cycle while monitoring the heart rate. Exercise testing helps evaluate how the heart responds to physical exertion. In cases where an individual is unable to exercise, the doctor may prescribe medications that simulate the effects of exercise on the heart. These medications aim to mimic the cardiovascular changes that would typically occur during exercise, providing valuable information about the heart’s function and response.
• Cardiac Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI). You typically lay on a table within a doughnut-shaped scanner for a heart CT scan. The machine’s internal X-ray tube spins around your body while taking pictures of your chest and heart. During a cardiac MRI, patients are positioned on a table that slides into a cylindrical machine resembling a tube. This advanced technology utilizes a combination of magnetic fields and radio waves to generate signals, which are then translated into detailed images of the heart.
• Cardiac catheterization. In order to inject dye into a cardiac artery, a doctor threads a thin tube (catheter) through a blood vessel in the arm or groin. As a result, the cardiac arteries are easier to see on an X-ray. The pressure inside the heart’s chambers can be evaluated during a cardiac catheterization to determine how vigorously blood is pumped through the organ. A tiny amount of cardiac tissue may occasionally be taken for a biopsy.
• Genetic examination. A test to determine if a hereditary condition is causing an individual’s enlarged heart.

Treatment

The appropriate treatment for an enlarged heart (cardiomegaly) depends on identifying and addressing the underlying cause of the heart issue. Once the specific cause has been determined, the treatment plan can be tailored accordingly.

Medications

The following medicines may be suggested by a doctor if cardiomyopathy or another form of cardiac problem is the reason for an enlarged heart:

• Diuretics. These medications assist lower blood pressure by lowering salt and water levels in the body.
• Other blood pressure drugs. To lower blood pressure and enhance heart function, physicians may prescribe beta blockers, Angiotensin-Converting Enzyme (ACE) inhibitors, or Angiotensin II Receptor Blockers (ARBs).
• Blood thinners. Anticoagulants, which thin the blood, may be administered to lower the risk of blood clots that could result in a heart attack or stroke.
• Heart rhythm drugs. These drugs, often known as anti-arrhythmics, aid in heartbeat regulation.

Surgery or other procedures

Medical devices and surgery can be required to treat an enlarged heart if drugs are ineffective.
Treatment for an enlarged heart may involve surgery or other techniques, such as:

• Pacemaker. A pacemaker is a little gadget that is often inserted close to the collarbone. The pacemaker is connected to the inner heart by one or more wires with electrode tips that travel through the blood vessels. The pacemaker emits electrical impulses that prompt the heart to beat steadily if the heart rate is too slow or stops.
• Implantable cardioverter-defibrillator (ICD). A surgeon may implant an implanted cardioverter-defibrillator (ICD) if your enlarged heart is causing major heart rhythm issues (arrhythmias) or if you are at danger of dying suddenly. Similar to a pacemaker, an ICD is a battery-operated device implanted under the skin close to the collarbone. The heart is reached by one or more electrode-tipped ICD wires that travel through veins. The heart rhythm is continuously monitored by the ICD. The heart rhythm is reset by low- or high-energy shocks when the ICD notices an irregular heartbeat.
• Heart valve surgery. Surgery may be required to replace or repair the afflicted valve if cardiac valve disease is the root cause of the enlarged heart.
• Coronary bypass surgery. This open-heart surgery may be performed to reroute blood flow around a blocked artery if an enlarged heart is caused by a blockage in the coronary arteries.
• Left Ventricular Assist Device (LVAD). Your doctor can suggest this implantable mechanical pump to help your heart pump if you have heart failure. While you are waiting for a heart transplant or, if you are not a candidate for a heart transplant, as a long-term treatment for heart failure, you may have a left ventricular assist device (LVAD) placed.
• Heart transplant. In cases where an enlarged heart is uncurable and other treatment options have been exhausted, a heart transplant may be considered as the final treatment option. However, the availability of donor hearts is limited, which can result in a significant waiting period, even for individuals who are critically ill and in need of a transplant.