Pay Close Attention to Early Enlarged Heart Symptoms

A prompt visit to your doctor may help prevent heart failure or other complications from damaging your cardiovascular health.


The early symptoms of an enlarged heart can be so subtle that they are easy to ignore: shortness of breath, swelling in the legs or abdomen, fatigue, dizziness, lightheadedness, fainting, an irregular heartrhythm.

If you experience any of these, don’t wait for them to worsen. See your doctor. “We need to start looking at what’s going on and decide what the possible cause could be,” says Cleveland Clinic heart failure specialist Miriam Jacob, MD.

Enlarged Heart Symptom Causes

An enlarged heart is a sign of heart failure. It can develop from a wide range of causes, including coronary artery disease (CAD), hypertension, valve disease, and cardiomyopathy.

Viruses can attack the heart muscle. Excessive alcohol consumption can damage the heart. Weakness of the heart can also be associated with thryoid disorders.

A disease called familial cardiomyopathy causes an enlarged heart to run in families. Some heart defects present at birth cause heart failure inadulthood.

Your doctor will determine the most likely cause based on your medical history and a physical exam. Often, the diagnosis can be confirmed with a painless echocardiogram.

Other tests can include cardiac magnetic resonance imaging (MRI), nuclear stress testing, cardiac catheterization or blood tests. Stress testing show how the heart functions during exertion, while cardiac catheterization can help diagnose valve problems, check the pumping ability of the heart, and look for other problems.

No matter the cause, an enlarged heart should be evaluated, as treatment may need to be started early.

Dilated cardiomyopathy

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Underlying Heart Disease

Heart attack from CAD is the leading cause of death among U.S. adults and a primary cause of heart failure. A healthy heart ejects 55 to 65 percent of its blood with each beat. After a heart attack, it may pump out much less. “When this is not enough to meet the body’s needs, the heart may grow larger to hold more blood,” Dr. Jacobexplains.

Likewise, when a heart valve is too stiff, the heart must pump harder. If it’s too loose, blood can flow backwards. Either way, the heart enlarges and complications ensue.

If these problems are not corrected, the heart will become progressively weaker. Fortunately, there are a number of things that can be done tohelp.

Treatments for an Enlarged Heart

Many patients with an enlarged heart due to heart disease are started on medications to help the heart pump more effectively. These include a beta- blocker and an angiotensin-converting enzyme (ACE) inhibitor, angiotensin receptor blocker (ARB) or a new drug called Entresto. Sometimes an aldosterone antagonist is added. This combination, called neurohormonal blockade, must be taken forlife.

“Our goal is to at least stabilize the function of the heart and normalize its size and function. If it recovers, we are very pleased, but it is reasonable to hope for improvement,” says Dr.Jacob.

Some patients also benefit from a biventricular pacemaker, one that paces both sides of the heart. Others benefit from stenting or coronary artery bypass surgery to improve blood flow to the heart muscle or valve replacement or repair.

Talk to a Cardiologist

If caught early, an enlarged heart can be treated by an internist or family physician. But heart failure is so complex and difficult to treat that it requires a specialist to ensure optimalcare.

“When someone has an enlarged heart, a consult with a cardiologist is a good idea. You may not need to be followed by a cardiologist forever, but it’s helpful to get a second opinion on your management plan,” says Dr.Jacob.

“If you’ve been told you have an enlarged heart, but you have no symptoms, you should definitely see a cardiologist to determine whether or not you need to start medications,” sheadds.

If you have a family history of heart failure, you may want to consult a genetic counselor. “The reason is to help your children or siblings understand their risk. They may benefit from getting echocardiograms every couple of years,” says Dr. Jacob.


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