What Is An Enlarged (Dilated) Heart?

When I was diagnosed with an enlarged heart, I wanted to learn more about it.

During my research, I learned that an enlarged heart, also known as a dilated heart, is not a disease in itself. Instead, it is a symptom of a disease. Called cardiomegaly, the term is most often applied in the interim between a physician noting that the heart is enlarged, perhaps on an X-ray, and a definite diagnosis based on further testing to identify the condition that has caused the heart to become enlarged. Treating an enlarged heart involves treating the condition that caused the cardiomegaly. The heart is a muscle, and like any other muscle, it can become larger if it is worked harder. 

Although the condition can sometimes develop without an apparent cause, it is usually the result of a condition that makes the heart work harder than it should. As the heart "bulks up," its primary function of pumping blood to the body becomes less efficiently addressed. High blood pressure, when left untreated, can overwork the heart. So, too, can arrhythmia, an abnormal heartbeat.

How Do Enlarged Hearts Relate To Valve Defects?

A defect or disease that damages one of the heart's four valves can lead to an enlarged heart. For example, aortic stenosis can lead to an enlarged heart. Patients with cardiomyopathy, a stiffening and thickening of the heart muscle that weakens it, may develop an enlarged heart as it labors to pump an adequate supply of blood to the body. Coronary artery disease, in which plaque in the arteries interferes with the flow of blood, can cause the heart to enlarge. Pulmonary hypertension is high blood pressure within the artery that connects the lungs and heart. It forces the heart to work harder to transfer blood between the heart and lungs, which may lead to an enlargement of the right side.

Thyroid problems, whether they involve an underactive or overactive thyroid, can cause a heart to enlarge. The build up of abnormal proteins in the heart or the inability to process iron efficiently, leading it to build up in the body, can lead to an enlarged heart. Chronic, untreated anemia can also cause an enlarged heart over a long period of time can cause the heart to enlarge, although it is relatively rare.

Enlarged Heart Symptoms

Some patients with an enlarged heart report no symptoms of the condition. Others may have: D

• Difficulty breathing
• Shortness of breath
• Feel lightheaded or dizzy
• Chest pain
• Heart arrhythmias (atrial fibrillation)
• Persistent cough
• Fluid retention that causes swelling. 

Complications with a dilated heart depend on which area of the heart is enlarged and what caused the specific patient condition.

Heart Failure Due To An Enlarged Heart

If the left ventricle is the area affected, the heart can weaken to the point that it cannot meet the body's demand for blood. This can lead to heart failure. An enlarged heart can also disrupt the heart's rhythm, resulting in cardiac arrest. Patients with an enlarged heart are also at greater risk of developing blood clots inside the heart that are attached to the heart's lining. If these clots break free, they can travel to another part of the heart, the brain, or the lungs, endangering the patient.

How Are Enlarged Hearts Treated?

To treat an enlarged heart, the physician must treat the condition underlying cause. Surgery to repair or replace a defective valve may be necessary. In some cases, a pacemaker or heart transplant may be indicated. However, certain medications may be used to treat symptoms, and they may prevent additional damage or lower the risk of serious complications. Diuretics are sometimes prescribed to decrease pressure in the heart and arteries by lowering the levels of water and sodium in the body. ACE inhibitors or angiotensin receptor blockers, or beta-blockers may be used to lower blood pressure and improve the pumping ability of the heart.

Most physicians urge patients with an enlarged heart to make certain lifestyle changes that may help improve the condition. Many of these are the same choices that lead to good overall cardiac health.

• Smoking and obesity should be avoided
• Alcohol consumption should be avoided or severely restricted.
• Diabetes and high blood pressure should be kept under control.
• Patients should restrict salt intake and sleep seven to eight hours a night.

Although it is often impossible to prevent an enlarged heart, early diagnosis and treatment can help prevent serious complications from developing. Patients with a family history of heart disease should advise their doctors of this fact. Following the physician's recommendations on controlling diabetes, high blood pressure and cholesterol can also be beneficial. Obese patients should consult their physicians about a weight reduction program.

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To help you learn more about enlarged hearts and heart valve disease, you may like:

• Can Enlarged Hearts Return to Normal After Surgery?
• Does Gender Impact Enlarged Hearts After Aortic Valve Replacement?
• How Can Calcified Heart Valves Impact Heart Size?
• Research Leading Heart Hospitals that Specialize in Valve Disease
• Meet Patients with Heart Valve Disease in Our Community
• Explore the Heart Valve Learning Center

Page last updated: May 23, 2022