Enlarged Heart

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KEY POINTS

• Most of the time, your heart gets enlarged from having high blood pressure (hypertension) for a long time. An enlarged heart muscle gets stiff and does not pump blood as well as a normal sized heart.
• Your healthcare provider will treat you based on your symptoms, your history, and your diagnosis. You may need medicine, a procedure to open a blocked blood vessel, a pacemaker, or heart surgery.
• Follow your healthcare provider’s advice about exercising, eating a healthy diet, watching your weight, not smoking, and checking your blood pressure.

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What is an enlarged heart?

An enlarged heart usually means that the muscle that forms the left ventricle is bigger than usual. The heart has 4 sections or chambers. The upper chambers are called atria, and the lower chambers are called ventricles. The left ventricle is the biggest of the 4 chambers.

Unlike other muscles in your body, your heart is not better when it works harder and gets bigger. An enlarged heart muscle gets stiff and does not pump blood as well as a normal sized heart.

This condition is also called left ventricular hypertrophy.

What is the cause?

Most of the time, your heart gets enlarged from having high blood pressure (hypertension) for a long time.

Normally, blood flows from the right atrium into the right ventricle, and the right ventricle pumps it to the lungs to pick up oxygen. Blood returns from the lungs to the left atrium, which pumps into the left ventricle. The left ventricle pumps blood out of the heart to the body. When you have high blood pressure, the left ventricle has to work harder to pump blood through your body.

Other less common causes of enlarged heart are:

• Heart valve disease
• Hypertrophic cardiomyopathy, which means that heart muscle cells get bigger and the walls of the heart muscle are thick
• Athletic hypertrophy, which is from exercise
• Heart disease that you are born with

Many risk factors affect your blood pressure and heart health in general. Your risk of having heart disease may be higher if you:

• Smoke, use alcohol, or use drugs such as cocaine
• Are overweight
• Don’t get enough exercise
• Have high levels of cholesterol
• Have diabetes, thyroid disease, or other long-term diseases
• Had rheumatic fever or other infections that affected your heart
• Have a family history of heart disease
• Are African-American

What are the symptoms?

You may have heart disease for years before you have major heart problems. You may have ongoing hypertension without symptoms.

Signs and symptoms may include:

• Shortness of breath, especially with activity
• Dizziness
• Chest pain, especially with activity
• Irregular heart beats
• Feeling very tired

If you have these symptoms, see your healthcare provider as soon as possible.

Call 911 for emergency help right away if you have symptoms of a heart attack. The most common symptoms include:

• Chest pain or pressure, squeezing, or fullness in the center of your chest that lasts more than a few minutes, or goes away and comes back (may feel like indigestion or heartburn)
• Pain or discomfort in one or both arms or shoulders, or in your back, neck, jaw, or stomach
• Trouble breathing
• Chest pain that doesn’t go away after you have taken nitroglycerin as your healthcare provider prescribed
• Breaking out in a cold sweat for no known reason

You may also feel very tired, faint, or be sick to your stomach. Severe tiredness may start several days before your heart attack symptoms.

How is it diagnosed?

Your provider will ask about your personal and family medical history, examine you, and do tests to check for heart disease. Tests may include:

• Echocardiogram, which uses sound waves (ultrasound) to see how well your heart muscle is pumping
• An ECG (also called an EKG or electrocardiogram), which measures and records your heartbeat
• Chest X-ray

How is an enlarged heart treated?

The treatment for heart disease and an enlarged heart depend on the cause, your symptoms, and any other health problems you may have. Follow your healthcare provider's advice about lifestyle changes that may help lower your risk of heart attack, stroke, or other problems caused by heart disease.

Treatment may include medicines to help control your heart beat and blood pressure. Your healthcare provider may treat other conditions that may be affecting your heart or your blood pressure also with:

• An angioplasty or surgery to open blocked arteries
• A pacemaker to treat fast, slow, or irregular heart rhythms
• Surgery to repair a damaged valve, or for serious disease, a heart transplant

If your heart is enlarged because of vigorous physical training and exercise, it usually returns to normal size over time when you stop training. Talk to your healthcare provider about any questions you have about training and exercise.

How can I prevent heart disease?

For all types of heart disease prevention and treatment, it is important for you to:

• Take care of your health.
  • Try to get at least 7 to 9 hours of sleep each night.
  • Eat a healthy diet and try to keep a healthy weight.
  • If you smoke, try to quit.
  • If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.
  • Learn ways to manage stress.
  • Exercise according to your healthcare provider's instructions.
• Treat and control medical conditions such as diabetes, high blood pressure, and high cholesterol. Get cholesterol and blood pressure screening tests as recommended by your healthcare provider.
• If you are a woman taking hormone replacement therapy, talk with your healthcare provider about the risks and benefits. Hormone replacement therapy may increase the risk for heart disease or stroke.
• Taking a low-dose aspirin every day may help prevent a heart attack or stroke. Not everyone should take aspirin. Ask your healthcare provider if you should take aspirin and if so, how much to take.
• See your healthcare provider if you have a sore throat or if you have been exposed to strep throat. Treating strep throat infections with antibiotics can usually prevent rheumatic fever. Rheumatic fever can damage the heart, joints, brain, and skin.
• Protect yourself against infections by getting all recommended vaccinations.