Cardiomegaly (Enlarged Heart)

What is Cardiomegaly?

An enlarged heart is a potentially life-threatening symptom of an underlying medical condition. Also known as cardiomegaly, it is characterized by the enlargement, thickening and/or stiffening of the heart muscle. In rare cases scar tissue can form. As a result, the heart must work harder to pump blood throughout the circulatory system.

The heart may simply appear to be enlarged (pericardial effusion) if fluid has accumulated in the sac that surrounds it. The reason for an enlarged heart is sometimes unknown.


  • Genetic defect
  • Heart valve disease
  • Coronary artery disease
  • High blood pressure
  • Viral injection
  • Lifestyle
  • Pregnancy
  • Pulmonary hypertension
  • Arrhythmia (irregular heartbeat)
  • Anemia
  • Thyroid disease
  • Diabetes
  • Build-up of iron in the heart and elsewhere in the body (hemochromatosis)
  • Amyloidosis (protein deposits in the heart)

What are the Symptoms of Cardiomegaly?

An enlarged heart does not always produce symptoms. When it does, there may be several.

Symptoms include

  • Water retention (edema)
  • Shortness of breath
  • Heart arrhythmia (irregular heart beat)
  • Weight gain, especially in the abdominal region
  • Lethargy

Cardiomegaly Causes

Cardiomegaly, or an enlarged heart, is primarily brought about by blockages that affect the blood supply to the heart, resulting in coronary artery disease and high blood pressure. An abnormal heart valve or a viral infection in the heart can cause the organ to become enlarged. In pregnant women, the heart may become enlarged as the time for delivery draws near, resulting in a condition known as peripartum cardiomyopathy.

A number of other factors contribute to increasing the chances of developing cardiomegaly, such as is the case with kidney disease severe enough to require dialysis. HIV positive individuals are also at a greater risk of developing an abnormally enlarged heart, as are those who frequently use alcohol and cocaine.

Additionally, research indicates that cardiomegaly may be an inherited condition, though more studies need to be conducted on the relationship between genetics and enlarged hearts.

How is Cardiomegaly Treated?

The treatment of an enlarged heart involves finding and targeting the cause.

Treatment includes:

  • Lifestyle changes
  • Stress management
  • Dietary changes
  • Weight management
  • Regular doctor-approved exercises
  • Cessation of tobacco use
  • Avoidance of alcohol
  • Blood pressure and heart-rate reduction medications
  • ACE inhibitors
  • Calcium channel blockers
  • Beta blockers
  • ARBs (angiotensin receptor blockers)
  • Digoxin
  • Diuretics or Lasix
  • Electrolyte balancing medication (aldosterone blockers)
  • Anti-inflammatories (corticosteroids)
  • Blood thinner
  • Surgical implants (cardioverter-defibrillator, pacemaker)
  • Ethanol injections (alcohol septal ablation)
  • Open-heart surgery
  • Heart transplant

With proper treatment and lifestyle changes, an enlarged heart can be successfully managed. However, life expectancy depends on the underlying cause of cardiomegaly.

Cardiomegaly Prevention

Individuals with a family history of heart disease, particularly such conditions of cardiomyopathy, should consult a doctor. Early actions may prevent heart-related conditions from worsening. In cases where there is a history of enlarged hearts in the family, individuals should take special care to practice a healthy heart lifestyle.

Making changes to avoid developing coronary artery disease is essential. This includes quitting smoking, keeping diabetes and blood pressure under control, and maintaining healthy cholesterol levels. A healthy diet and regular, daily exercise will help individuals maintain a healthy heart and avoid the conditions that increase the risk of developing an enlarged heart.

It’s also advised that alcohol is limited and drug use is eliminated from one’s lifestyle, as these factors also contribute to poor heart health. Stress relief and relaxation techniques may also help. Even in cases where cardiomegaly has developed, the individual may still be able to avoid heart failure by adopting these lifestyle recommendations.

Last Reviewed:
September 18, 2016
Last Updated:
November 28, 2017