Question: What causes an enlarged heart? What should I be doing if I’ve been told I have one? Is there any treatment?
Dr. Hibberd's Answer:
An enlarged heart can occur for numerous reasons. Damaged or malformed heart valves or mispositioned blood vessels may be the cause. Also, diseases or disorders of the heart, lungs, or blood vessels can be the culprit. Conditions that increase the load on this muscle, such as uncontrolled hypertension (high blood pressure), can result in an enlarged heart.
Treatment is directed at the cause of the enlargement and is specific for right- or left-sided heart enlargement or both, and whether hypertrophy of the muscle is present. Most heart failure almost always is caused by a disorder associated with an enlarged heart.
Effective management of your enlarged heart is very important, as most enlarged hearts are less efficient pumps and pump failure is seen more commonly in those who have enlarged hearts. For instance, some athletes suffer from an “athlete's heart" and require modification of activity and occasionally medications to help their hearts return to a more normal size.
Hypertension is a very common cause of left-ventricular enlargement and hypertrophy, and can be readily reversed by aggressive hypertension control.
Many of our heart failure treatment and preventive strategies are aimed at reducing the stressed, enlarged heart to a healthier, more efficient, non-dilated pump that provides blood to all areas of our body.
Your cardiologist may place you on agents (often ace inhibitors or beta-blockers) that decrease the stress on your heart and help it return to a more normal size by reducing wall tension and entry and exit pressure called "preload" and “afterload."
Lung conditions that affect resistance and impact heart stress may often be associated with heart enlargement or even heart failure, especially on the right side of the muscle.
An enlarged heart is not a healthy heart. Be sure to follow your cardiologist's advice carefully. Your heart size is evident on your EKG and ultrasound tests, so be sure to maintain regular follow-up, and control or minimize your risk factors contributing to your enlarged heart. You will live longer and more comfortably for the effort.
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