By Medically reviewed by hellodoktor

Know the basics

What is cardiomegaly?

The term “cardiomegaly” most commonly refers to an enlarged heart seen on a chest X-ray. Other tests are then needed to diagnose the condition causing your enlarged heart.

Cardiomegaly is not a disease, but sometimes accompany with  longstanding anemia and thyroid diseases.

How common is cardiomegaly?

Enlarged heart is common to people who have a history of high blood pressure or heart disease.  This affects the elder more popular than younger. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Know the symptoms

What are the symptoms of cardiomegaly?

In some people, an enlarged heart causes no signs or symptoms. Others may have these signs and symptoms like:

  • Shortness of breath;
  • Abnormal heart rhythm;
  • Swelling;
  • Weight gain;
  • Fatigue;
  • Palpitations or skipped heartbeats.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have new signs or symptoms that might be related to your heart, you should make an appointment to see your doctor.

Seeking emergency medical care if you have any of these signs and symptoms, which may mean you are having a heart attack:

  • Chest pain;
  • Severe shortness of breath;
  • Fainting.

Know the causes

What causes cardiomegaly?

Cardiomegaly can be caused by some conditions which make heart pump harder or damage your heart muscle. Moreover, for some people, they can be born with a congenital heart condition, or damage from a heart attack or an abnormal heartbeat may make your heart to enlarge. However, we have some conditions that you can consider:

  • High blood pressure can make your left ventricle become enlarge, causing the heart muscle weaken because your heart have to pump harder to delivery blood in body. Also, it could enlarge the upper chambers of your heart.
  • Heart valve disease: we have four valves in our heart to keep blood flowing. If the valves are damaged by rheumatic fever, heart defect, infections, connective tissue disorders, certain medications or radiation treatments for cancer, this would make your heart enlarge.
  • Disease of the heart muscle may make you heart easy to get enlarge because of trying to pump more blood for our body.
  • Fluid around your heart: when accumulation of fluid in the sac (pericardium) that contains your heart, may cause your heart to appear enlarged on a chest X-ray.
  • Low red blood cell count: anemia is a condition in which there are not enough healthy red blood cells to carry adequate oxygen to your tissues. If you do not treat well, chronic anemia can lead to a rapid or irregular heartbeat. Your heart must pump more blood to make up for the lack of oxygen in the blood.
  • Thyroid disorders: both an underactive thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism) can lead to heart problems, including an enlarged heart.
  • Excessive iron in the body: hemochromatosis is a disorder in which your body does not properly metabolize iron, causing the build up in various organs, including your heart. This can cause an enlarged left ventricle due to weakening of the heart muscle.

Know the risk factors

What increases my risk for cardiomegaly?

There are many risk factors for cardiomegaly, such as:

  • High blood pressure will increase the risk of developing an enlarged heart.
  • If your parents or siblings have had an enlarged heart, you may be more susceptible to developing the condition.
  • With coronary artery disease, fatty plaques in your heart arteries obstruct blood flow through your heart vessels, which can lead to a heart attack. When a section of heart muscle dies, your heart has to pump harder to get adequate blood to the rest of body.
  • If you are born with congenital heart disease,  you may be at risk of developing an enlarged heart.
  • The heart has four valves such as aortic, mitral, pulmonary and tricuspid. All of them have to open and close to direct blood flow through your heart. With valvular heart disease condition,  this can damage the valves and cause the heart to enlarge.
  • Having a heart attack increases your risk of developing an enlarged heart.

Understand the diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is cardiomegaly diagnosed?

These tests may include:

  • Imaging tests can detect your problems by showing an image of your chest. Common tests are Chest X-ray, Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI).
  • Electrocardiogram: this test records the electrical activity of your heart through electrodes attached to your skin. This test helps your doctor diagnose heart rhythm problems and damage to your heart from a heart attack.
  • Echocardiogram: this test for diagnosing and monitoring an enlarged heart uses sound waves to produce a video image of your heart. With this test, the four chambers of heart can be evaluated.
  • A stress test, also called an exercise stress test, provides information about how well your heart works during physical activity. This test usually involves walking on a treadmill or riding a stationary bike while your heart rhythm, blood pressure and breathing are monitored.
  • Your doctor may order blood tests to find the problem of your heart.
  • Cardiac catheterization and biopsy: in this procedure, a thin tube is inserted in your groin and threaded through your blood vessels to your heart. If indicated, this can be extracted for laboratory analysis.

How is cardiomegaly treated?


If cardiomyopathy or another type of heart condition is to blame for your enlarged heart, your doctor may recommend medications, such as:

  • Diuretics to lower the amount of sodium and water in your body, which can help lower the pressure in your arteries and heart.
  • Angiotensin-converting enzyme (ACE) inhibitors to lower your blood pressure.
  • Angiotensin receptor blockers (ARBs) to provide the benefits of ACE inhibitors for those who cannot take ACE inhibitors.
  • Beta blockers to lower blood pressure and improve heart function.
  • Digoxin to help improve the pumping function of your heart and lessen the need for hospitalization for heart failure.
  • Anticoagulants to reduce the risk of blood clots that could cause a heart attack or stroke.
  • Anti-arrhythmics to keep your heart beating with a normal rhythm.

Medical procedures and surgeries

If medications are not enough to treat your enlarged heart, medical procedures or surgery may be necessary.

  • Medical devices to regulate your heartbeat. For a certain type of enlarged heart (dilated cardiomyopathy), a pacemaker that coordinates the contractions between the left and right ventricle may be necessary. For those people who may be at risk of serious arrhythmias, drug therapy or an implantable cardioverter-defibrillator (ICD) may be an option.
  • ICDs are small devices that is implanted in your chest to continuously monitor your heart rhythm and deliver electrical shocks when needed to control abnormal, rapid heartbeats. The devices can also work as pacemakers.
  • If the main cause of your enlarged heart is atrial fibrillation, you may need procedures to return your heart to regular rhythm or to keep your heart from beating too quickly.
  • Heart valve surgery: if your enlarged heart is caused by a problem with one of your heart valves, you may have surgery to remove the valve and replace it with either an artificial valve or a tissue valve from a pig, cow or deceased human donor.
  • Coronary bypass surgery: if your enlarged heart is related to coronary artery disease, your doctor may recommend coronary artery bypass surgery.
  • Left ventricular assist device (LVAD): if you have heart failure, you may need an implantable mechanical pump to help your weakened heart pump. With an LVAD implanted, you can wait for a heart transplant. Or if you are not a heart transplant candidate, LVAD could treat your heart for a long term.
  • Heart transplant: in case that medications could not control your symptoms, a heart transplant may be a final option.

Lifestyle changes & Home remedies

What are some lifestyle changes or home remedies that can help me manage cardiomegaly?

The following lifestyles and home remedies might help you cope with cardiomegaly:

  • Quit smoking;
  • Lose excess weight;
  • Limit salt in your diet;
  • Control diabetes by reducing consumed sugar;
  • Monitor your blood pressure;
  • Get modest exercise, after discussing with your doctor the most appropriate program of physical activity;
  • Avoid alcohol and caffeine;
  • Try to sleep at least eight hours per day.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: August 19, 2016 | Last Modified: September 11, 2019

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