health matters

Health Talk: Cardiomegaly

What Cardiomegaly Is

Cardiomegaly refers to a condition in which the heart becomes larger than its normal size, due to a heart disease. This is brought by high blood pressure, or even by other heart conditions and other non-cardiac matters such as long-term anemia.

There are two types of cardiomegaly namely: dilated cardiomegaly and hypertrophic cardiomegaly. In dilated cardiomegaly, the heart becomes enlarged brought about or caused by the dilation of the heart muscle. It could also cause the heart to become weakened and enlarged, followed by a congestive heart failure. DCM signs and symptoms include those of left and/or right heart failure. An example of this condition would be dilated cardiomyopathy, a most common form of non-ischemic cardiomyopathy

Hypertrophic cardiomegaly, on the other hand, the heart muscle undergoes hypertrophy when placed under a tedious workload for a prolonged period. An example is the left ventricular hypertrophy (LVH) which is the most common form or type of hypertrophic disease. LVH is caused by chronic hypertension. This is where the left ventricle increases contractility and/or preload in order to maintain the same stroke volume.

A. Dilated Cardiomegaly/Cardiomyopathy

B. Hypertrophic Cardiomegaly/Cardiomyopathy

How Is Cardiomegaly Diagnosed?

Cardiomegaly can be diagnosed through a physical exam and test recommended by a doctor. These tests include chest x-ray (images would help the doctor see your heart and lung condition) , electrocardiogram (records the heart’s electrical activity by means of attaching electrodes in your body. This also helps in diagnosing heart rhythm problems and damage), echocardiogram (ultrasound image of the heart and helps the doctor see how your heart efficiently pumps blood, examine which heart chamber is enlarged, look for evidence of heart attack and even determine if you have a congenital heart problem) , stress test (also known as exercise stress test which provides information on how well the heart progresses during a physical activity. This type of test involves a treadmill stress test or even riding a stationary bike in which your heart rhythm, blood pressure and breathing is being monitored), cardiac computerized tomography or magnetic resonance imaging (these types of test require you to lie down on either doughnut shaped machine/gantry or on a table in a long tube machine. In a cardiac CT, images of your heart and chest gets collected through a use of an X-ray tube inside the machine which rotates around your body. While in a cardiac MRI, a magnetic field and radio waves are used in order to produce signals that would create images of your heart.) , blood tests (another test done that checks the levels of certain blood substance that may possibly point out to a heart problem and this helps the doctor rule out other conditions that may be causing the symptom) and cardiac catheterization and biopsy (a type of test or procedure done wherein a thin tube or catheter is being attached or inserted in your groin area and threaded through your blood vessel going to the heart, extracting a small sample of your heart for a laboratory analysis. 

A. Chest x-ray

B. Electrocardiogram

C. Echocardiogram 

D. Stress Test 

E. Computerized tomography and MRI 

D. Cardiac catheterization and biopsy

What Causes Cardiomegaly?

There are several possible causes of an enlarged heart or cardiomegaly. It may be an idiopathic (unknown) cause, congenital heart problem, damage from a heart attack or an arrhythmia. It may also be associated with other conditions such as high blood pressure, heart valve disease, heart muscle disease/cardiomyopathy, pulmonary hypertension, pericardial effusion, anemia, thyroid disorder (e.g. hypothyroidism/hyperthyroidism) , hemochromatosis and other rare disease that may affect the heart (e.g. amyloidosis).

Cardiomegaly may also be brought about by the viral infection of the heart, peripartum cardiomyopathy, kidney disease, alcohol or cocaine abuse and even HIV infection.

What Are The Symptoms Of Cardiomegaly?

A cardiomegaly may or may not have any signs or symptoms in some people. Some possible signs or symptoms of an enlarged heart include shortness of breath, abnormal heart rhythm, increased abdominal girth, weight gain, fatigue, swollen leg, palpitations or skipped heartbeats, cough, edema, and chest pain.

Who Are At Risk of Cardiomegaly?

Possible risk factors of an individual to develop an enlarged heart or cardiomegaly include: having a family history of cardiomyopathy, valvular heart disease, coronary artery disease, hypertension (high blood pressure) , congenital heart disease, heart attack, obesity and cardiac ischemia.

What Are The Possible Complications of Cardiomegaly?

When left untreated, cardiomegaly may pose life-threatening complications on an individual. Some of these include heart failure, blood clots, heart murmur, or worst.. cardiac arrest and sudden death.

What are the Medications and Treatments for Cardiomegaly?

A doctor may possibly recommend certain medications or surgical treatments to be done for cardiomegaly.

A. Medications

Certain medications for cardiomegaly include diuretics (lowers the amount of sodium and water and helps in lowering the pressure of arteries in the heart) , angiotensin-converting enzyme inhibitors (lowers the blood pressure and improves the heart’s pumping capability), angiotensin-receptor blockers (provides the ACE inhibitor’s benefits for those patients who can’t take them) , beta-blockers (lowers blood pressure and improves the heart function) , Digoxin (helps to improve the heart’s pumping function and lessens the need for hospitalization for heart failure) , anti-coagulants (reduces the risk of blood clot that possibly causes heart attack or stroke), anti-arrhythmics (keeps the heart beating normally).

B. Treatments

When the medications don’t seem to help enough, surgical treatments may be needed. These surgical treatments are: medical devices to regulate the heartbeat (e.g. ICD – continuously monitors the heart rhythm and delivers electrical shocks, should there be a need to control abnormal heartbeats) , heart valve surgery, coronary bypass surgery, left ventricular assist device or LVAD (an implantable mechanical pump used to help a weakened heart to pump) and heart transplant (a final yet critical option when all else fails)

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