Cardiomegaly is a condition when the heart is enlarged due to certain diseases. Cardiomegaly can be temporary , it can also be permanent . In some cases, this condition can occur without causing symptoms. However, there is also cardiomegaly which causes dizziness, weakness, and shortness of breath.

Cardiomegaly is not a disease, but a symptom. Usually, these heart defects occur as a result of a disease or condition that causes the heart to have to work harder to pump blood.

Cardiomegaly can be seen through imaging tests, such as X-rays. The presence of cardiomegaly is generally not an emergency. However, it is important to find out the cause of cardiomegaly, so that appropriate treatment can be given and complications can be prevented.

Causes and Risk Factors of Cardiomegaly

Cardiomegaly occurs when the heart muscle pumps blood with a greater effort than normal. This excessive workload will eventually cause thickening of the heart muscle, so that the size of the heart becomes larger.

Some conditions that can cause cardiomegaly are:

  • Hypertension or high blood pressure
  • Coronary heart disease
  • Heart valve disorders
  • Cardiomyopathy
  • Arrhythmia (irregular heart rhythm)
  • Pericardial effusion or fluid buildup in the lining covering the heart
  • Thyroid hormone disorders
  • Anemia
  • Excess iron in the body ( hemochromatosis )
  • Viral infection of the heart
  • HIV infection
  • Kidney disease, such as kidney stones
  • Lung disease, such as chronic obstructive pulmonary disease (COPD)
  • Amyloidosis disease
  • Congenital heart disease, such as atrial fibrillation, coarctation of the aorta , or Ebstein's anomaly
  • Pregnancy

In addition to the conditions above, the risk of cardiomegaly is also higher in someone with the following factors:

  • Are overweight or obese
  • Have a passive or sedentary lifestyle
  • Alcohol or drug addiction
  • Have had a heart attack
  • Have a family history of heart swelling

Cardiomegaly Symptoms

Cardiomegaly does not always show symptoms. However, in some sufferers, this condition begins with mild symptoms, such as heart palpitations and shortness of breath during moderate activity, which persist for years.

Usually, new cardiomegaly shows symptoms that are more pronounced when the heart's ability to pump blood has decreased significantly. Symptoms of cardiomegaly can include:

  • Shortness of breath, especially when doing strenuous activities
  • Heart rhythm disturbances ( arrhythmias )
  • The body feels tired quickly
  • Swelling ( edema ) in the legs or all over the body
  • Weight gain due to fluid buildup
  • Dizzy

When to see a doctor  

The sooner it is detected and treated, the more likely it is for cardiomegaly to be cured. Therefore, it is advisable to immediately see a doctor if you experience the symptoms mentioned above, especially if you are one of those at risk of suffering from this condition.

Seek immediate medical attention if symptoms of a heart attack appear, such as:

  • Discomfort in the upper body, such as the back, stomach, arms, neck and jaw
  • Chest pain
  • Severe shortness of breath
  • Faint

Cardiomegaly diagnosis

Diagnosis of cardiomegaly begins by asking about the symptoms experienced and the patient's medical history. Next, the doctor will carry out a physical examination, especially of the heart, by feeling and tapping the chest wall area, and listening to heart sounds through a stethoscope.

After that, additional cardiac examinations need to be carried out to determine the condition of the enlarged heart and its causes. Additional checks that can be done include:

  • Chest X-ray , to see the size of the heart and lungs
  • Electrocardiogram (EKG), to see the electrical activity of the heart to check heart rhythm and the condition of the heart muscle
  • Echocardiography or ultrasound of the heart, to determine the thickness of the muscles, the size of the heart chambers, the work of the heart valves, and the ability of the heart to pump
  • CT scan or MRI, to show a more detailed picture of the heart
  • Stress test ( exercise test ), to monitor the ability of the heart to work while the patient is doing physical activity, such as walking on a treadmill or riding a stationary bicycle
  • Blood tests, to determine the levels of certain substances in the blood that are affected by diseases or conditions that cause cardiomegaly
  • Cardiac catheterization , to check the pressure in the chambers of the heart or see coronary heart disease
  • Cardiac biopsy, to take a sample of the heart muscle tissue

Cardiomegaly Treatment

Cardiomegaly treatment focuses on addressing the cause of the enlarged heart. Treatment options that can be done include administering drugs or surgery, depending on the cause and severity.

To treat cardiomegaly caused by high blood pressure or heart failure, the cardiologist can prescribe ACE inhibitors , such as captopril, or beta blockers , such as bisoprolol. These drugs function to lower blood pressure and improve heart pumping function.

If the patient cannot take ACE inhibitors , the doctor can replace them with ARB drugs , such as candesartan. In addition, diuretic drugs can also be given to reduce sodium and water levels in the body so that blood pressure decreases and swelling decreases.

To treat causes of cardiomegaly related to heart rhythm, doctors can prescribe antiarrhythmic drugs, such as digoxin . If the patient is at risk of suffering a stroke or heart attack, the doctor can also give blood thinners .

When the administration of drugs is not effective enough to overcome the causes of cardiomegaly, treatment may be carried out by surgery. Some of the operations that can be done to treat cardiomegaly are:

  • Installation of a pacemaker or implantable cardioverter-defibrillator (ICD), to monitor and control heart rhythm
  • Heart bypass surgery , to treat blockage of the heart arteries in cardiomegaly caused by coronary heart disease
  • Heart valve surgery, to replace a problematic valve
  • Heart transplant or transplant, as a last resort if other medical procedures do not treat cardiomegaly

The chances of successful cardiomegaly treatment will be greater if it is supported by lifestyle changes to become healthier, such as:

  • Exercise regularly
  • Manage stress well
  • Maintain an ideal weight
  • Limit salt consumption
  • Get enough sleep, about 8 hours a day
  • Stop smoking
  • Stop or limit consumption of alcoholic or caffeinated drinks
  • Maintain blood sugar levels and blood pressure

Cardiomegaly that occurs temporarily, for example due to pregnancy or infection, usually recovers completely and the heart will return to its normal size. However, if cardiomegaly is caused by a chronic disease, this condition is usually permanent so treatment needs to be continued.

Cardiomegaly Complications

If not treated properly, cardiomegaly can cause the following complications:

  • Heart valve disorders
  • Formation of blood clots in the heart that can block blood flow to vital organs
  • Heart failure
  • Sudden cardiac arrest

Cardiomegaly Prevention

Cardiomegaly can be avoided by taking precautions against the disease and risk factors that can cause this condition. This can be done by living a healthy lifestyle to maintain heart health, such as:

  • Eat foods that are good for people with an enlarged heart, such as fruit, vegetables, fish, low-fat milk, and whole grains
  • Limit consumption of salt and saturated fat
  • Avoid alcoholic beverages
  • Stop smoking habit
  • Exercise regularly
  • Maintain cholesterol levels and blood pressure
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