In the other types, the muscular left ventricle becomes very thick. High blood pressure may cause your left ventricle to enlarge (a type known as hypertrophy). The thickening (which doctors call hypertrophic cardiomyopathy) can also be inherited.
An enlarged heart keeps more of its pumping ability when it's "thick" rather than "thin."
- Viral infection of the heart
- Abnormal heart valve
- Pregnancy, with the heart enlarging around the time of delivery (your doctor may call this peripartum cardiomyopathy)
- Kidney disease that needs dialysis
- Alcohol or cocaine abuse
- HIV infection
- Genetic and inherited conditions
Frequently, no cause is known. Your doctor may refer to this as idiopathic dilated cardiomyopathy.
- Shortness of breath (especially when active or when lying flat)
- Leg swelling
- Weight gain, particularly in your midsection
- Tired feeling
- Palpitations or skipped heartbeats
Some folks may never have symptoms. Others may have little things that don’t change for years. Still others may have shortness of breath that steadily gets a little worse.
An enlarged heart may be discovered after you and your doctor talk about symptoms you have that could be tied to congestive heart failure. Other times, it’s found out through a test for something else.
- Muscle thickness
- Pumping function
In some cases, it can help your doctor figure out what’s causing your enlarged heart.
Other things can help discover an enlarged heart, such as:
Your history: Shortness of breath or other symptoms of congestive heart failure may provide clues.
A physical exam: You may have swelling. An enlarged heart can also produce abnormal sounds when a doctor listens with a stethoscope.
Chest X-ray: Dilated cardiomyopathy increases the heart’s size on a chest X-ray film.
Blood tests: These may be done to check for things that can lead to enlarged heart, such as:
CT scans and MRIs: These may help diagnose an enlarged heart in certain situations.
Biopsy: Very rarely, a doctor may obtain a small tissue sample from inside the heart to determine the cause of an enlarged heart.
Often, these focus on the underlying cause, such as:
Coronary artery disease: Opening the blockages in the blood vessels that supply oxygen to the heart can improve blood flow to the heart muscle. If your heart is enlarged because of a blockage, its pumping may improve.
Alcohol or drug use: Stopping use of the harmful substance can improve the symptoms of an enlarged heart and improve heart function.
Diuretics. "Water pills" make you pee more. This means the heart doesn’t have to pump as much. These also help ease leg swelling.
Implantable cardioverter-defibrillator. A device put into the chest can restart the heart if it stops beating. Some of these can also help the heart pump more effectively.