Valve Disease and Enlarged Heart — Different heart valve diseases lead to different types of heart enlargement which although initially felt to be compensatory remodeling ultimately lead to heart failure if left untreated. In aortic stenosis , the valve through which blood has to go through to leave the heart becomes tight, increasing pressure and stress on the wall of the heart known as pressure overload. The heart becomes thick to compensate in a form of enlarged heart called concentric hypertrophy.
The thick heart, although pumps well, does not relax well and that can lead to heart failure, and if not treated in time can lead to severely reduced heart function and weak muscle. In aortic regurgitation , that same valve is leaky and there is a different type of stress in addition known as volume overload.
Aortic regurgitation is somewhat unique in that there is pressure and volume overload leading to both enlarged heart chambers and thick heart muscle. In mitral regurgitation the mitral valve that separates the upper and lower chambers of the left heart is leaky. A classic cause for this leak is mitral valve prolapse. In mitral regurgitation the heart is placed under a volume overload stress and the heart enlarges by increased chamber size and often-thinner walls in a process known as eccentric hypertrophy.
Unfortunately if the heart is to get too enlarged in mitral regurgitation even correction of the leak with surgery or interventional procedures such as the Mitraclip will not improve the heart function that will often be reduced after surgery.
We most commonly talk about left sided enlarged heart however it is important to identify right-sided heart enlargement also. The right side of the heart is not able to cope with large pressures in the same way the left side does, so in periods of stress it may enlarge and fail immediately.
Examples of causes of acute right-sided heart enlargement include pulmonary embolism clot in the lungs or a right-sided heart attack. Other important causes include holes in the heart , leaky tricuspid valve , or increased pressures in the lung arteries known as pulmonary hypertension.
A large amount of clot is seen floating in the right side of the heart as it passes through on its way to the lung where is will result in a pulmonary embolism. Below we will discuss some of the treatments for enlarged heart. Enlarged heart, depending on the cause may return to normal size if appropriate and timely treatment is given. In many cases it will not however, in which case the goal is prompt recognition and treatment to stabilize the situation and prevent further enlargement.
Reversible causes include early stages of hypertensive heart caused by high blood pressure, early stages of significant valvular heart disease, early stages of a heart attack, and sudden onset weaknesses of the heart muscle known as cardiomyopathies that may include pregnancy related, stress related or viral.
The right side of the heart has a remarkable ability to bounce back from acute strain and treatment of the underlying cause may often lead to resolution of the enlargement completely.
Treatment of enlarged heart depends on the underlying cause. Above we have talked about many of the causes, however there are many other causes which we do not exactly know the cause of. In enlarged heart of high blood pressure, meticulous blood pressure control is key and can certainly lead to regression of the enlargement to varying degrees. In a heart attack and other cardiomyopathies, the process of remodeling can be somewhat attenuated by taking medicines such as ACE-Inhibitors and beta-blockers that can lead to improvement of heart function and regression of enlargement.
In valve disease, treatment at the appropriate time, prior the onset of full-fledged failure, can often lead to regression of heart enlargement. Important to recognize however is that not only can the appropriate treatment prevent or improve enlargement, it may save lives.
Many thanks. My Father had large heart His lungs was full of water. Is this a family history. I have high blood pressure and on blood thinner. This is Family history of large heart. I have just been told i have an enlarged heart. My blood pressure is normal. I dont smoke. I am worried. Disclaimer: The comment response is opinion and in no way affiliated with my employer.
Talking about your challenges and feelings could be an important part of your journey to recovery. To find useful services to help you on your journey with heart disease, see our services and resources listings. Donate now. Heart disease Conditions A-Z Enlarged heart. What is an enlarged heart? Types The heart can enlarge in two ways: Dilatation: The heart walls become thin, stretch out dilate and weaken.
This enlarges the heart. Dilated cardiomyopathy can lead to heart failure , where the heart loses its ability to pump properly. Hypertrophy: The heart walls thicken causing the heart to become less efficient. This can happen in athletes and pregnant women, whose hearts undergo a high workload for long periods of time.
Left ventricular hypertrophy LVH is the thickening of the muscle of the left lower heart chamber ventricle — the main pumping chamber of the heart. Cardiac catheterization: A long, thin flexible tube is threaded through a blood vessel in the arm or groin and to the heart.
Contrast material is injected through the tube and a type of X-ray video is taken to show how the heart functions and to look for heart blockages.
A small piece of heart tissue may be taken for lab analysis. Chest X-ray: A common imaging test of the lungs, heart and aorta. Computed tomographic angiography CT : This non-invasive test can show the arteries in the abdomen, pelvis and legs.
This test is particularly useful in patients with pacemakers or stents. Electrocardiogram EKG : An EKG measures the electrical activity of the heart and can detect an enlarged heart as well as determine if a heart is overworked or damaged. Magnetic resonance imaging MRI : A large magnet, radio waves and a computer are used to produce pictures of the heart and blood vessels. Stress testing: This test is conducted during exercise. If a person can't exercise, medicine is given to increase heart rate.
Exercise makes the heart work hard and beat fast while heart tests are administered. Enlarged Heart Causes Enlarged heart cardiomegaly can be caused by any condition that forces your heart to work harder, most commonly by heart diseases.
Enlarged heart can also arise from factors that can include: Blocked arteries of the heart coronary heart disease Disease of the heart muscle cardiomyopathy High blood pressure High cholesterol High blood pressure in the artery leading to the heart and lung pulmonary hypertension Tobacco, alcohol and cocaine use Enlarged Heart Risk Factors Enlarged heart risk factors can include: Anemia : A lack of red blood cells that carry oxygen to the blood can cause the heart to beat faster and enlarge the heart.
Congenital heart disease: People can be born with a heart that has an abnormal structure that may cause an enlarged heart. Connective tissue disease: Conditions like Marfan Syndrome can contribute to an enlarged heart. Excessive iron in the body : When iron is not metabolized, it can collect in the heart and enlarge the left ventricle.
Fluid around the heart: Fluid can collect around the heart and cause the heart to pump harder, which causes enlargement. Heart attack: A previous heart attack can lead to an enlarged heart.
Healthy eating and lifestyle changes can help to manage high blood pressure. Hypertension, or high blood pressure, can increase your risk of heart attack, kidney failure and stroke.
Heart Foundation of Australia warns of the risk of high blood pressure and tells you what you can do to keep your blood pressure down. CPR is a life-saving skill that everyone should learn from an accredited organisation.
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