Enlarged Heart: Symptoms, Causes & Treatment

What is an enlarged heart?

Having an enlarged heart, or cardiomegaly, means that your heart is bigger than it should be in relation to how big your body is. A bigger person usually will have a larger heart than a smaller person, but when the increased heart size is out of proportion with the person’s body size, it becomes a problem.

An enlarged heart is usually a sign of an underlying medical issue that is causing the heart to have to grow in order to function properly. When a heart enlarges, it can follow one of two patterns: Either the walls of the heart can get thicker, or the chambers of the heart can enlarge and expand. In either case, these changes affect the heart’s ability to work correctly.

Is having an enlarged heart serious?

Depending on the cause of the enlarged heart, it may or may not be reversible. Over time, an enlarged heart can cause serious health problems. Most notably, it can increase the risk of sudden death.

In addition, it can cause fluid to build up in the body and lungs, which can lead to heart failure. It can also prompt blood clots to form in the heart and travel throughout the body, which – depending where the blood clots travel – can cause a stroke, heart attack, or severe damage to any other organ in the body.

An enlargement of the heart is therefore a serious condition that should be diagnosed promptly and medically addressed as soon as possible. But as we'll see below, the causes, signs, and symptoms are not simple to identify.

What causes an enlarged heart?

There are many different causes of an enlarged heart. As people get older, chronic underlying medical problems can gradually lead to enlargement of the heart.

Any medical condition that increases the amount of force the heart has to generate to pump blood, or increases the amount of blood the heart has to pump, may lead to an enlargement in the heart over time. The most common conditions that increase how hard the heart has to squeeze to pump blood effectively include high blood pressure (called hypertension) and heart valve problems.

Any medical condition that directly damages the heart, such as a heart attack, or certain infections can also lead to a weakening of the heart muscle and an increase in size over time. In young people, these conditions are often inherited.

This is why it is so important to know your family history! It is also possible for certain viruses, drugs, and other chronic medical issues to cause an enlarged heart.

Athletes can also be more susceptible to certain conditions with links to sudden cardiac arrest and death. The heart is a muscle, so just like a bicep or quadricep, the more it gets used, the bigger it can grow. With exercise and physical activity, it is normal for a person’s heart to get thicker and stronger. However, unlike inherited conditions that cause heart enlargement, the thickening of a heart muscle that occurs with exercise is not dangerous and does not increase the risk of sudden death.

Are there any signs or symptoms of an enlarged heart?

One of the challenging aspects of identifying people with an enlarged heart is the fact that, often, people with an enlarged heart don’t experience any symptoms. While there are many possible symptoms caused by an enlarged heart, sometimes a cardiac arrest could be the first sign, which is why heart screenings are so important. There may, however, be warning signs, including the following:

  1. Fainting or seizure during or immediately after exercise.
  2. Unexplained shortness of breath.
  3. Dizziness
  4. Extreme fatigue.
  5. Racing heart (feels like it is beating out of your chest).
  6. Sudden and unexplained death of a family member under the age of 50 (e.g. drowning, auto accident, sudden infant death syndrome (SIDS)).

Download our warning signs sheet to learn more.

How is an enlarged heart diagnosed?

There are multiple ways that an enlarged heart can be diagnosed. Occasionally, there are signs that a doctor may be able to pick up on by listening to the heart or examining a patient.

However, often times, there are no signs of an enlarged heart that are visible to the eye. In that case, doctors may use other tests such as an electrocardiogram (ECG), which is a recording of the electrical activity of the heart.

An even better test for finding an enlarged heart is an echocardiogram, a test that uses sound waves to take pictures of the heart, which can show the actual size and function of a heart in real time.

What are the treatment options for an enlarged heart?

The first step is identifying the problem and diagnosing the enlarged heart. Given that some people do not have any symptoms, this can be challenging. Once someone has been found to have an enlarged heart, the treatment depends on the cause of the problem, as well as the severity of the condition.

Often times, medications can be used to help improve the function of the heart. Other patients will require some sort of procedure or surgery, like placement of an implantable cardioverter defibrillator (ICD), which monitors your heart rhythm and responds if a dangerous rhythm is detected. In addition to taking medications, those individuals that are found to have an enlarged heart will need to routinely follow up with doctors to monitor the function of the heart and sure that they doing well.

Ultimately, if someone is found to have an enlarged heart, their doctor will evaluate their symptoms and risk factors to determine the right treatment for them.

How does Simon’s Heart help?

We provide free heart screenings to identify young people at risk for heart-related problems before they occur. We believe that every student should get a heart screening. We screen our kids’ eyes and ears – why not their hearts?

A heart screening, with a physical exam, thorough medical history, and ECG is the most effective way of detecting conditions that can lead to sudden cardiac arrest and death if left untreated. Find a heart screening near you. Find a specialist near you. For more information about enlarged hearts, visit our Best Resources List.