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Enlarged Heart (Cardiomegaly)

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Diagnosis of an Enlarged Heart

An enlarged heart may be discovered after a person discusses symptoms of congestive heart failure with a doctor. Other times, it is discovered in someone without symptoms who gets a test for other reasons.

Echocardiography (ultrasound of the heart) is the preferred test to diagnose an enlarged heart. There is no pain or risk from an echocardiogram. It can accurately measure the heart's:

  • size
  • muscle thickness
  • pumping function

In some cases, echocardiography can suggest potential causes for an enlarged heart.

Doctors may use various other tests to help diagnose an enlarged heart, such as:

History. Shortness of breath or other symptoms of congestive heart failure may provide initial clues to the presence of an enlarged heart.

Physical exam. Swelling may be present. And an enlarged heart may produce abnormal sounds when a doctor listens with a stethoscope.

Chest X-ray. The type of enlarged heart called dilated cardiomyopathy produces an abnormally large shadow on a chest X-ray film.

Cardiac catheterization. During this procedure to detect blockages in the coronary arteries, the heart's size and pumping function can also be checked.

Blood tests. These may be done to check for causes of enlarged heart, such as:

  • congestive heart failure
  • thyroid disease
  • HIV or other viral infection

CT scans and MRIs. These may help diagnose an enlarged heart in certain situations.

Biopsy. Very rarely, a doctor may recommend taking a small tissue sample from inside the heart to determine the cause of an enlarged heart.

Treatments for an Enlarged Heart

When possible, treatments for an enlarged heart focus on the underlying cause, such as:

Coronary artery disease. Opening the blockages in the blood vessels supplying oxygen to the heart (cardiac catheterization with stenting) can improve blood flow to the heart muscle. If an enlarged heart is due to a blockage, the heart's pumping may improve.

Hypertension. Controlling high blood pressure can prevent further damage and improve function in the enlarged heart.

Alcohol, drug, or medication use. Stopping use of the harmful substance can lead to improvement in the symptoms of an enlarged heart and improve heart function.

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