Why does a person's heart become enlarged? What is an enlarged heart? Pathological causes of heart enlargement

An enlarged heart can be diagnosed in both an adult and a child. However, we should not forget that such pathology in children differs in its causes, symptoms and treatment.

If during a routine preventive examination of the chest it is determined that the heart is enlarged on fluorography, then there is no need to panic in advance. It is recommended to go for a consultation with a cardiologist and understand the reasons that led to the changes.

The cause of an enlarged heart in an adult is often hypertrophy of the left ventricle of the heart, sometimes the right, or both. In some cases, expansion of both atria is also noted. In this case, the organ is so deformed that it cannot function normally.

Expansion of the boundaries of the heart is called cardiomegaly. Enlargement of the heart chambers is often caused by the accumulation of metabolic products in the heart muscle, which means that true cardiomegaly develops.

Sometimes this phenomenon is detected during excessive physical activity, in pregnant women, and in athletes. In this case, the expansion of the heart is not considered dangerous. More often, during exercise, the lower chambers enlarge, especially the left ventricle, since it is from here that blood is released into the systemic circulation.

The exact etiology of the problem is established after diagnosis.

Important! The pathology detected in a newborn is very dangerous, since about 35% of children with it die in the first three months of life, and 20% develop chronic left ventricular failure.

Causes

Why does the heart enlarge? A number of reasons have been identified that lead to pathology:

• Pregnancy period.
• Diabetes mellitus together with high blood pressure.
• Long-term antibiotic therapy.
• Heart defects.
• Inflammatory processes in the heart area.
• Rheumatism, especially with stagnation of blood.
• Alcohol – it adversely affects the heart muscle and the entire body. If you abuse alcohol for more than 10 years, there is a risk of developing alcoholic cardiomyopathy.
• High blood pressure is more common in older people, and the heart expands to the left as the left ventricle enlarges.
• Cardiomyopathy - formation occurs due to infection in the heart muscle or due to alcohol abuse, and the increase is small.
• Anemia.
• Kidney failure.
• Pulmonary hypertension is an enlargement of the right side of the heart.
• Playing sports - athletes often experience an enlargement of the heart muscle, this is considered normal. Dangerous disorders occur when the heart muscle becomes very large and training is irregular.
• Myocardial infarction – most often the entire myocardium enlarges, and an aneurysm often forms.

An enlarged heart is not often observed for the following reasons:

• Muscle dystrophy.
• Loose closure of the tricuspid valve leaflets during ventricular contraction, with an increase in the diameter of the heart muscle on the right.
• Diseases of the endocrine glands.
• Hypertrophic cardiomyopathy - thickening of the walls of the left ventricle and dystrophy of the heart muscle often leads to stagnation of blood, and then to expansion of the heart to the left.
• Infiltrative-restrictive cardiomyopathy is characterized by the presence of inextensible ventricular walls that resist filling with blood.
• Cancerous tumor or metastases going to the heart.
• Bacterial infections in the heart.

Symptoms

Enlargement of the heart muscle appears in relation to individual individual chambers, less often it is observed in all chambers. Pathology usually develops due to additional stress on the organ, which has to do more work than usual. That is, muscle mass is gained with increased blood pumping. This is especially noticeable in inflammatory lung diseases, which lead to oxygen starvation.

It is worth remembering that there are no characteristic signs of pathology; it is manifested by symptoms of the diseases that led to its development. The following is most often observed:

• Severe shortness of breath even with little physical exertion.
• Swelling of the lower extremities and other parts of the body.
• Feeling of heaviness on the right side under the ribs.
• Pain in the head, which is accompanied by tinnitus.
• High blood pressure.
• Dry, causeless cough that gets worse when lying down.
• Pain in the retrosternal region on the left.
• Fast fatiguability.
• Dizziness to the point of loss of consciousness (the rarest symptom).

Attention! Often there are cases of asymptomatic progression, then the pathology is discovered by chance during a routine examination.

Enlarged heart in children

An enlarged heart in a child most often occurs due to congenital defects. In medicine, more than 90 defects have been identified, which are characterized by narrowing and insufficiency of the valves, deformations of the heart itself or the vessels feeding it. All of them lead to circulatory disorders.

Certain congenital defects cause the death of a child, so it is important to diagnose them as soon as possible (from the first days of life to six months) in order to carry out cardiac surgical treatment. This is done by cardiologists and cardiac surgeons.

In a child, an enlargement of the heart muscle can be caused by diseases such as hypertrophic cardiomyopathy, rheumatism and myocarditis of various origins. Endocarditis and pericarditis occur much less frequently in childhood. In such situations, the increase is not observed immediately after birth, but develops gradually.

Diagnostics

Modern medicine has developed a large number of diagnostic methods for detecting heart diseases. Making a diagnosis begins with collecting an anamnesis, which is based on the patient’s complaints and examination. The doctor clarifies the presence of chronic diseases, bad habits of the patient, and previous surgical interventions. Next, the following research methods are prescribed:

1. Chest X-ray - the image clearly shows the shadow of the expansion of the heart, and blood stagnation is detected.
2. Electrocardiography (ECG).
3. Echocardiography (EchoCG) determines the physical parameters of the heart muscle, including the size of the chambers, the presence of necrosis and ischemia of the heart.
4. Ultrasound of the heart muscle.
5. Computed tomography (CT).
6. Magnetic resonance imaging (MRI).
7. Immunological and biochemical blood test, which determines the level of hemoglobin, bilirubin, urea, protein and hormones.

Important! The effectiveness of treatment directly depends on the correct diagnosis and cause of the disease. Therefore before. Before treating pathology, the doctor carefully studies the results of tests and instrumental studies.

Treatment

Treatment directly depends on the causes of the disease. All activities are primarily aimed at organizing a healthy lifestyle for the patient and eliminating the cause of the disease. The patient is recommended a special diet that excludes fatty, salty and spicy foods, and giving up bad habits. The doctor prescribes special exercises.

The following medications may be prescribed:

• Medicines from the group of diuretics, which remove excess fluid from the body, thereby easing the load on the heart.
• Anticoagulants are medications that block the formation of blood clots and eliminate the risk of ischemia or alleviate its symptoms.
• Means for normalizing cardiac activity.

Surgical intervention is prescribed only in emergency cases when the patient's life is at risk. The most dangerous and advanced form is considered to be “bull heart”, in this case only a transplant can help.

If disturbances occur against the background of valve pathology, then prosthetics are performed. In case of severe heart rhythm disturbances, a pacemaker is installed under the skin to normalize it.

Important! For prevention and additional therapy, traditional medicine is used.

The heart is the most vulnerable human organ; its performance is affected by many internal and external factors. An enlarged heart indicates that there are certain problems in the body. Therefore, if unpleasant symptoms appear, it is recommended to immediately seek advice from a cardiologist, who will prescribe the necessary treatment, otherwise the consequences can be disastrous.

Enlarged heart, or cardiomegaly, is an extremely specific pathology, accompanied by an expansion of all 4 cardiac chambers. Popularly, a pathological condition such as cardiomegaly is called “bull heart”. But a big heart is not always good. Due to the development of this pathological condition, severe hypertrophy of the organ and disruption of its functions are observed.

Often, an increase in the size of the heart muscles is observed in people who lead a very active lifestyle and devote a lot of time to sports exercises, but at the same time the heart muscles also develop evenly. If a similar pathology is observed in people who are not actively involved in sports, there is an increase in the size of the ventricles, but the heart muscles themselves are quickly depleted and cannot normally compress the hypertrophied ventricles. Pathological enlargement of the heart in size can be a consequence of many heart diseases.

Reasons for development

Normally, men's hearts are much larger than women's. It is now known that the normal heart volume in men is approximately 760 cm³, while in women around 580 cm³ is considered good. It is believed that such a difference in heart size among representatives of different sexes is due to different volumes of the chest. As a rule, an enlarged heart is observed in adults, while in children such pathological changes in the structure of organ tissue occur extremely rarely. The most common causes of cardiomegaly in adults include:

• pregnancy;
• difficult childbirth;
• idiopathic cardiomyopathy;
• aortic insufficiency;
• stenosis;
• pulmonary heart;
• renal failure;
• cardiac ischemia;
• effusion in the pericardial sac;
• inflammation of the heart muscle;
• rheumatic heart disease;
• systemic lupus erythematosus;
• aortoarteritis;
• scleroderma;
• severe stress;
• septic endocarditis;
• severe anemia;
• high blood pressure;
• arterial hypertension;
• alcohol and drug addiction;
• Chagas disease.

Normally, the work of the entire heart is ensured by strong elastic muscles, but with the development of a pathological condition such as cardiomegaly, there is a rapid increase in the volume of organs and a decrease in the amount of muscle tissue. As the heart increases in size, there is a gradual decrease in blood output and a slowdown in its circulation throughout the human body.

As all the walls of the heart hypertrophy, it loses its ability to provide normal blood flow to all tissues of the body, which provokes the development of congestive processes. Developing compensatory phenomena, although at first they can provide the body with the necessary level of blood supply, subsequently no longer allow the heart to fully pump blood, and the development of heart failure and premature death of a person is observed.

Symptoms

For a long time, ongoing changes in the tissues of the heart may remain unnoticed by patients, especially if there are other diseases that occur with severe symptoms. In addition, it should be borne in mind that there are simply no specific symptoms of an enlarged heart. The thing is that many of the signs present in a condition such as cardiomegaly are characteristic of primary diseases that provoke tissue hypertrophy. In completely healthy people, the following symptoms may indicate the development of cardiomegaly:

• heaviness in the right hypochondrium;
• dry cough;
• swelling of the legs and whole body;
• increased fatigue;
• chest pain.

At first, such manifestations may be quite weakly expressed. However, as tissue hypertrophy occurs, symptomatic manifestations begin to increase as the heart gradually loses its ability to perform its function. The consequences of expansion of the walls of the heart and enlargement of the ventricles can be the most unfavorable.

Diagnosis and treatment of cardiomegaly

Modern diagnostic methods do not allow detecting an increase in heart volume in the early stages, since the symptomatic manifestations of this dangerous condition can be a consequence of other diseases of the cardiovascular system, which often confuses even qualified cardiologists. To confirm the diagnosis, the following activities are carried out:

• radiography;
• palpation;
• listening;
• echocardiogram;
• catheterization;
• blood chemistry;
• biopsy.

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In rare cases, when an increase in heart volume is detected in the early stages, this process can be stopped with medication. When the disease has already entered into full force, the main treatment should be aimed at the root causes of this pathological condition. Depending on the nature of the root cause of the problem, treatment can be carried out using both medical and surgical methods.

As a rule, medications are prescribed that help stabilize the heart in case of one or another primary disease.

Among other things, the patient must observe a special regime of wakefulness and activity, as well as a special gentle diet. It is very important to eat small portions and avoid overeating. Surgical treatment involves ventricular myotomy. Such a surgical intervention cannot be performed on all patients, as it is associated with a high risk of death on the operating table. In severe cases, when other treatments do not have the necessary effect, a heart transplant is required.

A large heart is a disease characterized by enlargement of all four chambers of the muscular organ. Muscle tissue acquires hypertrophied size and loses its former functionality. In medicine, this pathology is called cardiomegaly.

Causes

Most often, large heart disease is a consequence of other pathologies. People suffering from hypertension are primarily at risk. High blood pressure puts a lot of stress on the cardiovascular system. At this moment, the heart muscle experiences strong tension, begins to stretch and increase in size, and the organ itself hypertrophies at this time.

An enlarged heart can also be a consequence of:

• ischemic disease;
• congenital pathology;
• alcoholism;
• inflammation of the heart muscle (carditis);
• complications caused by viral infections;
• severe stress;
• renal failure.

With coronary artery disease, blood flow to the heart decreases, which causes a malnutrition of muscle tissue. Due to nutritional deficiency, cardiac muscle cells begin to degenerate and are replaced by connective tissue. Unlike muscle, connective tissue is not elastic and cannot contract. As a result, the ventricular cavities are stretched.

Carditis that occurs against the background of streptococcal infection (tonsillitis, scarlet fever) can also cause heart disease. Pathological changes in the inflamed muscle lead to its atrophy and enlargement.

"Heart of an Athlete"

People involved in professional sports are also susceptible to cardiomegaly. This is due to the fact that regular intense physical activity requires the heart to work more actively. This in turn leads to an increase in the size of the muscle tissue of the heart.

Over time, excessive stress can lead to pathological expansion of the ventricular cavities. This happens due to non-compliance with the training regimen.

"Beer Heart"

A separate group suffering from cardiomegaly includes people who regularly drink large quantities of beer. In such patients, there is an increase in the load on the heart, which has to pump a larger volume of blood than in normal conditions. The organ includes compensatory mechanisms, which causes an increase in the heart muscle and stretching of the cavities of the ventricles. The muscle begins to change its structure, becomes flabby and adipose tissue begins to appear in it. This in turn can lead to the development of heart failure.

Symptoms

Often, a pathology characterized as a large heart may not manifest itself for a long time. Most often, the disease is diagnosed by X-ray examination.

But sometimes an enlarged heart can manifest itself with the following characteristic signs:

• dyspnea;
• difficulty breathing at night;
• the appearance of edema;
• increased fatigue;
• chest pain;
• sweating;
• heart rhythm disturbance.

Before prescribing treatment, a diagnosis is carried out to identify the disease that caused cardiomegaly.

Diagnostics

To diagnose the disease, the following measures are taken:

• radiography;
• echocardiogram;
• CT scan;
• blood chemistry;
• caterization.

Palpation and auscultation are also performed to detect cardimegaly. As practice shows, it is very difficult to diagnose a large heart, since the disease has symptoms characteristic of other cardiovascular diseases.

Treatment

Therapy to eliminate big heart syndrome is primarily aimed at eliminating the root cause that caused the disease. In particular, medical and surgical treatment methods are used.

Drug therapy

An enlarged heart caused by hypertension or coronary artery disease is treated with medications to lower blood pressure. The attending physician prescribes the following medications:

• ACE inhibitors;
• beta blockers;
• diuretics.

ACE inhibitors can normalize blood pressure and improve cardiovascular activity. When taken over a long period of time, as prescribed by a doctor, they can return the heart to its normal, original state.

Beta blockers may be prescribed instead of inhibitors for hypertension. They help normalize blood pressure and heart rate.

When treating hypertension, it is also important to take diuretics, which remove excess fluid from the body and reduce the amount of sodium. This helps reduce the density of the heart muscle.

The group of ACE inhibitors includes the following medications:

• Enapril;
• Monopril;
• Renitek;
• Diroton.

With coronary heart disease, cardiomegaly can occur without an increase in blood pressure. In this case, the doctor may also prescribe inhibitors and drugs aimed at strengthening the heart muscle. An integral part of drug treatment for ischemia is diet therapy.

Diet therapy

Proper nutrition plays an important role in the treatment of pathologies that cause a large heart.

The patient's diet should include foods low in fat and high in fiber. This product category includes:

• vegetables;
• fruits;
• garlic;
• legumes;
• oatmeal;
• berries;
• low-fat fermented milk products.

Vegetables, fruits and berries are a source of potassium and magnesium, which have a beneficial effect on the cardiovascular system and strengthen it. In addition, many of this category of products are rich in vitamin C, which also helps strengthen the walls of blood vessels.

Oatmeal is a source of selenium and helps normalize blood pressure. Therefore, it must also be included in the diet of heart patients.

A very important product for heart diseases is garlic, which can not only normalize blood pressure, but also strengthen the heart muscle. Heart patients are recommended to eat two cloves of garlic daily.

Protein foods include lean chicken, turkey, rabbit and fish. They are a source of fatty acids, which are essential for the functioning of not only the heart, but the entire body.

All food consumed must be steamed or boiled in water.

Patients with heart disease are strictly prohibited from eating fried, salty and fatty foods, as they lead to clogging of blood vessels and retain excess fluid in the body.

You should also avoid tonic drinks and sweets, as they increase blood pressure.

Surgical intervention

If a large heart has caused heart failure, you may need to install an implantable cardioverted defibrillator, which is a matchbox device. Due to electrical discharges, the device allows the heart to beat at a normal rhythm.
A pacemaker may also be used to control the contraction of the heart muscle.

Prevention

To prevent the development or recurrence of heart pathologies, it is necessary, first of all, to change your approach to nutrition.

All foods that contribute to the formation of cholesterol plaques on blood vessels, which are the main cause of cardiovascular diseases, should be removed from the daily diet.

You should eat as many vegetables, fruits and freshly squeezed juices as possible, which are a source of potassium, magnesium and vitamin C.

Moderate physical activity plays an important role in the prevention of heart disease and other heart diseases. Exercising will strengthen the heart muscle and reduce the risk of developing heart pathologies. Even in old age, light aerobic exercise is prescribed. You should begin to gradually train your heart to increase its endurance and strengthen muscle tissue. At the very least, you should regularly engage in swimming or long walks in the fresh air.

When diagnosed with a large heart, it is also very important to give up bad habits: smoking and alcohol. These highly toxic products greatly increase the load on the cardiovascular system and provoke the development of heart diseases.

Following these simple rules will soon help bring the condition of the heart and blood vessels back to normal.

Cardiomegaly or enlarged heart is a pathology characterized by the expansion of all four cardiac chambers, as a result of which the organ acquires hypertrophied size and loses its functionality. Although not independent, the disease becomes a consequence of numerous cardiac ailments.

An enlarged heart often occurs in people who lead an active lifestyle, devoting most of their time to sports and physical activity. This is quite natural: the active process of pumping blood effectively trains the heart muscle, as a result of which its mass and size increase. In this case we are not talking about pathology.

Bovine heart syndrome occurs when the heart muscle is exhausted. Weak muscle fibers are not able to provide increased blood flow into the enlarged heart ventricles. The disease occurs when the muscles are unable to effectively support the functioning of the large heart. A person suffering from high blood pressure often runs the risk of becoming the owner of a bull's heart. In conditions when you have to overcome hypertension in the blood vessels, a large heart works harder and wears out faster. As a result, heart failure, heart attack, and stroke develop.

Causes

Despite the achievements of modern medicine, specialists cannot always determine the cause of the disease. However, the most common ones are:

• systematic increase in blood pressure;
• ischemic disease;
• numerous viral infections that target the heart;
• renal failure and other kidney diseases;
• congenital anomaly of the heart;
• pregnancy and childbirth;
• excessive alcohol consumption, drug addiction;
• cases of intrauterine development of the syndrome indicate a genetic predisposition;
• inflammation of the heart muscle;
• complications after suffering from tonsillitis, scarlet fever, influenza;
• severe stress, exposure to psycho-emotional overload;
• rheumatic carditis, septic endocarditis.

The paradox of the disease is that a large heart contains a minimal amount of muscle tissue. But it is the strong elastic muscles that are responsible for the effective functioning of the cardiovascular system.

It is necessary to systematically train the heart muscle. Moderate physical activity along with adequate therapy will help return the heart to normal volumes.

Diagnostics

As medical statistics show, diagnosing bovine heart disease is often very difficult. The patient may complain of feeling unwell, and the symptoms may indicate the presence of other ailments. Experts use the following diagnostic methods:

• echocardiogram;
• palpation and auscultation;
• radiography;
• CT scan;
• blood chemistry;
• caterization;
• biopsy.

Timely consultation with a doctor, high-quality diagnosis, and a properly designed treatment regimen can quickly restore health and prevent the development of complications.

Treatment

Usually, Treatment of bull's heart syndrome is aimed at the root cause, the underlying disease. The exception is congenital heart defects. Depending on the etymology of the underlying disease, medical and surgical treatment methods are used. People of the older age category are advised to eliminate the manifestations of coronary and hypertension. When taken systematically and carefully, medications help lower blood pressure and restore the effective functioning of the main organ. These include Enam, Enap, Diroton, Monopril and other angiotensin-converting enzyme inhibitors.

Drug treatment may be aimed at removing excess fluid from the body due to kidney failure. Rheumatic carditis and myocarditis are quite difficult to treat even with the most modern drugs. To prevent these diseases, it is necessary to increase the body's resistance through physical exercise and hardening.

Surgical intervention is an extreme measure that is resorted to when it is necessary to replace a damaged heart valve and stimulate the functioning of blood vessels. The nature and result of treatment directly depends on the etymology, prerequisites of the disease, and the patient’s condition at the current period of time. Numerous traditional medicines have proven themselves to be effective as prophylaxis and adjuvant therapy. It is worth remembering that the final diagnosis can only be made by a specialist based on research results. Self-medication is dangerous due to the development of complications and poses a direct threat to life.

In some cardiovascular diseases, an enlarged heart is detected. This pathology does not bode well, since decompensation can occur at any time and then there is a threat of developing heart failure. Therefore, if you have risk factors, you need to monitor your condition and, if it is violated, consult a doctor in a timely manner.

An enlarged heart (cardiomegaly or “bull heart”) is characterized by an increase in the size of the cardiac chamber or. Such a pathological process is known as. Often, heart enlargement is a reaction to stress to which the heart muscle is exposed. Hypertrophy may initially be part of a compensatory response, but it actually turns out to be somewhat detrimental.

Cardiomegaly is not an independent disease, since it mainly develops against the background of other pathological conditions such as obesity, hypertension, and coronary heart disease.

Diagnosing an enlarged heart is not difficult. More questions usually arise during treatment. The use of medications very rarely significantly improves the condition. Most often, medications must be taken for the rest of your life to avoid serious complications.

Video: Big heart disease (cardiomegaly)

Causes of heart enlargement

There are several ways to enlarge the heart, which often involve a process of ventricular hypertrophy and myocardial remodeling.

• High blood pressure and enlarged heart.

The heart, as a rule, must overcome the pressure created by the vascular system while pumping blood throughout the body. With normal blood pressure, this does not pose any particular difficulties for the myocardium. If blood pressure is high, the heart experiences a certain load. This puts stress on the myocardium, which struggles to do its job at this point.

If a person goes to the gym and lifts weights, his muscles become larger in response to the load. This process is called hypertrophy.

The heart enlarges in the same way; Only the problem that arises is associated with several consequences. Firstly, myocardial hypertrophy does not always return to normal size. Second, the disease fundamentally changes the architecture of the heart in a way that can lead to problems in the future, such as excessive relaxation and dysfunction of the affected muscle.

• Concentric enlarged heart

Heart enlargement is quite strongly associated with. In particular, during a myocardial infarction, a certain part of the heart muscle may die. The affected area becomes depleted and then a scar forms. This increases the load on the affected area of ​​the heart, which causes other areas of the myocardium to become more active to compensate for the resulting disturbance.

Redistribution of stress causes the heart to increase in size, which takes some time. This process is called remodeling. Unfortunately, if this remodeling cannot be prevented to some extent, cardiac function declines as a result. This may happen in the future.

• Congenital enlargement of the heart

A certain genetic predisposition leads to the fact that the size of the heart exceeds established normal values. The most classic example of this is the disease, which often contributes to sudden death in athletes.

The enlarged heart of hypertrophic cardiomyopathy is a disordered arrangement of fibers that make up the heart muscle. The pathology can lead to fatal cardiac arrhythmias and also impede blood circulation in the heart itself. In hypertrophic cardiomyopathy, the thickness of the myocardium increases.

There is also a congenital enlargement of the heart known as dilated cardiomyopathy. With this pathology, the walls of the heart become thin, while the size of the heart chamber increases, and the pumping function of the heart can greatly decrease.

• Valve disease and enlarged heart

Various heart valve diseases lead to cardiac enlargement, which was initially thought to be compensatory remodeling, and ultimately leads directly to heart failure if the disease is not treated.

In aortic stenosis, the valve through which blood passes to enter the aorta becomes tight, which increases pressure and stress on the walls of the heart chambers, known as pressure overload. The heart becomes enlarged, which allows it to compensate for the resulting disturbances for some time.

A hypertrophied heart, despite the fact that it contracts well, relaxes poorly and can lead to heart failure. If the pathology is not treated promptly, it can lead to a significant decrease in heart function and weakening of the myocardium.

In aortic regurgitation, the same valve allows blood to flow backwards. In this case, another type of stress develops, also known as volumetric overload. Aortic regurgitation is somewhat unique in that it combines pressure and volume overload, which directly leads to cardiac chamber distension as well as myocardial enlargement.

In mitral regurgitation, the mitral valve, which separates the upper and lower chambers of the left side of the heart, also leaks. The classic cause of this leak is mitral valve prolapse. With mitral regurgitation, the heart is under volumetric stress. Enlargement of the organ occurs by increasing the size of the chamber and reducing its walls in a process known as eccentric hypertrophy. Unfortunately, if the heart becomes too enlarged with mitral regurgitation, even correcting the leak with surgery or endoscopic procedures such as Mitraclip may not improve cardiac function. After surgery it will usually be reduced. Therefore, timely diagnosis of various forms of enlarged heart and appropriate treatment of heart diseases are important.

• Right-sided dilated heart

Most often they talk about left-sided enlargement of the heart, but it is also important to identify changes in the right half of the organ. This side of the heart is not able to cope with high pressure as intensely as the left side, so under stress it can quickly increase and break down just as quickly.

Examples of causes of acute right-sided heart enlargement are as follows:

• Pulmonary embolism.
• Right-sided heart attack.
• Tricuspid valve insufficiency.
• Increased pressure in the arteries of the lungs, known as pulmonary hypertension.

Echocardiogram of pulmonary embolism: a large clot is located on the right side of the heart as it travels to the lungs, where a pulmonary embolism develops.

Enlarged heart - can it return to normal?

An enlarged heart, depending on the cause, may return to normal size if prompt treatment is given. In many cases, however, this does not occur, in which case the goal of therapy is to quickly determine the cause and provide treatment to stabilize the situation and prevent further development of cardiomegaly.

Reversible causes include:

• Early stages of hypertensive heart disease caused by high blood pressure.
• Early stages of significant congestive heart disease.
• The early stages of a heart attack and sudden weakness of the heart muscle, known as cardiomyopathies, which may be associated with pregnancy, severe stress or a viral infection.

The right side of the heart has a remarkable ability to recover from acute stress, so treating the underlying cause can promote full recovery.

Video: Cardiomegaly, stretching of all cavities of the heart, rhythm disturbance of DCM

Treatment and recovery

Treatment for cardiomegaly will depend on the condition of the heart and concomitant diseases. Medical intervention or surgery may be required if the disease is not controlled with medications and lifestyle changes.

Drug treatment

Medicines can help reduce the severity of symptoms and in some cases help eliminate the causes, for example:

• Lower blood pressure.
• Prevents the formation of blood clots.
• Reduce the risk of heart attack or other complications.
• Increases the strength and efficiency of heart contractions.

Surgery

• Coronary artery bypass surgery - This surgery improves blood circulation, relieves chest pain and prevents heart attacks by using grafted arteries or veins taken from other parts of the body. This anastomosis allows you to bypass narrowed coronary arteries.
• Implantation of an auxiliary device to stimulate the functioning of the ventricles - with the help of this device, weak heart muscle contracts more effectively.
• Heart valve surgery—surgery may be performed to reconstruct or replace it with an artificial valve taken from a cow, pig, or human, or made from artificial materials.
• A heart transplant operation is an extreme method of solving problems with a diseased heart that cannot be restored by any means possible today.

Recovery after surgery

The length of hospital stay depends on the surgery.

• After coronary artery bypass surgery, the patient spends one to two days in the intensive care unit and another three to five days in another unit before he can go home. Full recovery may take 6-12 weeks. Only a doctor can tell exactly when a patient can be physically active again, including returning to work or resuming sexual activity.
• Recovery after implantation of a ventricular stimulator depends on the general condition of the patient before surgery. Typically, the patient spends one to two days in the intensive care unit and another three to five days in another unit before he can go home. Sometimes you have to make a gradual transition home from the hospital, which involves staying at home during the day but returning to the hospital in the evening. The doctor, as a rule, informs about the acceptable level of activity that can be maintained until the recovery process is completely completed.
• After heart valve surgery, you typically have to spend one to two days in the intensive care unit and another three to five days in another unit before you are allowed to go home. Full recovery may take 6-12 weeks. The doctor basically tells you when the patient will be able to be physically active again.
• After heart transplant surgery, you must spend several days in the intensive care unit and several weeks in another unit before you are allowed to go home. After discharge, you will be required to remain in close proximity to the hospital for the first six weeks to maintain required visits and laboratory testing. When the opportunity arises, the doctor informs you about the acceptable level of physical activity, which you can adhere to until the body fully recovers.

Postoperative care

Before leaving the hospital, the doctor or nurse will provide a follow-up plan, which will likely include examinations and laboratory tests. It is important that daily medical examinations are performed to reduce the risk of additional artery blockages:

• A diet low in fat, cholesterol and salt should be practiced.
• You need to do physical therapy exercises every day.
• It is important to avoid the use of tobacco products and alcohol.
  It is necessary to reduce stress levels as much as possible.
• If you have risk factors such as high blood pressure and others, you should take medications prescribed by your doctor every day.

Complications

If an enlarged heart is not diagnosed early and not treated early, complications may occur, including:

• Thrombosis . Blood clots can weaken the heart and affect its ability to pump blood throughout the body. If pieces break off from the blood clot, then such emboli spread through the bloodstream and can block a blood vessel anywhere in the body. Cardiac arrest or sudden death, stroke and pulmonary embolism are all diseases associated with thromboembolism.
• Heart failure . As the left ventricle enlarges, the risk of heart failure increases. As it develops, the ventricles stop contracting normally and effectively pumping blood.
• Valve insufficiency . Blood can flow backwards if the valves (most often the mitral and tricuspid valves) do not close tightly and properly. This creates a characteristic sound called a heart murmur. Although it may not be harmful, a doctor should monitor the patient's condition regularly.

Key points

• Enlarged heart, or “bull’s heart,” is a serious disease that, without treatment, is complicated by heart failure.
• The occurrence of an enlarged heart is most often associated with other diseases such as genetic disorders, hypertension, and heart defects.
• Treatment of an enlarged heart is carried out according to indications. In some cases, medication is sufficient, but there may be a need for surgical intervention.
• After the operation, there must be a recovery period, which, depending on the severity of the disease, can be two or more weeks.
• Cardiomegaly is dangerous due to its complications, since in severe cases sudden death, valve insufficiency, etc. can occur.

Video: Hypertrophic cardiomyopathy. Big heart disease