In their practice, doctors often come across people with heart disease. More often this applies to elderly or senile patients. In some cases, pathologies of the heart are also found in the able-bodied population. Newborns who have acquired defects in the prenatal period are no exception. One of the symptoms of such pathologies is an enlarged heart. This symptom is common in many cardiological diseases. An increase in heart muscle usually indicates a long-term pathology that led to heart failure.
Cardiomegaly - what is it?
Normally, the size of the heart is individual for each. They depend on the complexion of a person, gender, age. It is believed that the size of the organ is approximately equal to the size of a palm clenched into a fist. Nevertheless, there are limits that separate the norm from pathology. An enlarged heart is called cardiomegaly. It can be detected both during a physical examination, and thanks to instrumental diagnostics. In most cases, the ventricle of the heart is enlarged, mainly the left. Less commonly, cardiomegaly occurs due to the right departments. An increase in the organ appears due to hypertrophy of the muscle layer, as well as due to myocardial stretching (dilatation). This phenomenon rarely occurs in the short term. Cardiomegaly is usually preceded by a prolonged chronic illness.
Enlarged heart: causes of pathology
Cardiomegaly can occur due to many reasons. It depends on the patient's age, hereditary predisposition, body weight and lifestyle. Sometimes an enlarged heart is considered a normal variant. In this case, cardiomegaly should be moderate. Such cases include constant physical activity, pregnancy, rarely adolescence. A significant increase in heart size in this category of people is also a pathology. The following causes of cardiomegaly are distinguished:
- Congenital malformations (CHD). They form during pregnancy, can be of various sizes. With large or combined defects, heart failure occurs quickly. In this case, cardiomegaly can occur in the first months of a child's life. If the defects are insignificant, the enlargement of the heart occurs gradually, sometimes it does not occur at all.
- Inflammatory diseases. These include myo-, endo- and pericarditis. Most often, these pathologies occur in childhood and adolescence. Cardiomegaly is observed only in cases where the disease has acquired a chronic form. Also, this group includes dilated myopathy.
- Acquired heart defects. Formed in adulthood. Most often they are a consequence of rheumatism.
- Chronic cardiovascular disease. These include myocardial ischemia (heart attack, angina pectoris), arterial hypertension.
- Chronic lung disease. Among them - bronchial asthma, COPD.
- Pathologies of other organs and systems. An enlarged heart can be observed with severe anemia, renal and hepatic insufficiency, hyperthyroidism.
- Metabolic syndrome (obesity in combination with diabetes).
The mechanism of development of cardiomegaly
The pathogenesis of cardiomegaly depends on the cause. Most often, left ventricular hypertrophy occurs in people with metabolic syndrome, coronary heart disease, or arterial hypertension. With a small supply of oxygen, the heart muscle contracts more than usual, and gradually increases in size. About the same thing happens with hypertension. In this case, the heart does not have time to pump blood fast enough because of its high pressure, so the body needs more effort. The mechanism of development of cardiomegaly is different with stenosis and valve insufficiency. In the case of these pathologies, the blood does not completely enter the adjacent chamber or vessel (aorta, pulmonary artery) and causes stretching of one of the parts of the heart. With long-term defects, both the ventricle and the atrium increase. In some cases, hypertrophy of the entire organ may occur. Right ventricular failure occurs with pulmonary pathologies, liver diseases.
Symptoms with an enlarged heart
Symptoms of an enlarged heart can be expressed to varying degrees. With left ventricular hypertrophy, patients complain of shortness of breath. Attacks of lack of air occur during exercise, weight lifting, fast and long walking. With severe cardiomegaly, shortness of breath can also be at rest. In addition, some patients have edema syndrome. Most often, fluid accumulates on the lower third of the legs in the evening. If ischemia is the cause of heart failure, patients are concerned about pain in the heart region. Also, the clinical picture depends on the cause of cardiomegaly. With pulmonary pathologies, cough, suffocation is added to the listed symptoms. Hepatic insufficiency is characterized by massive edema (ascites, anasarca), swelling of the cervical veins. Elderly people with an enlarged heart often have hypertension.
How to diagnose cardiomegaly?
There is insufficient history to detect cardiomegaly. For this, it is necessary to palpate and percussion of the organ. When the heart is tapped, it becomes clear to the doctor whether its size corresponds to the norm or goes beyond its borders. In addition, an x-ray of the chest is performed. With cardiomegaly, the outline of the organ in the images is increased. To determine in which departments hypertrophy is observed, an ECG is performed. Thanks to this study, one can also find out about the cause of the disease (ischemia, lung pathology). Echocardiography (ultrasound of the heart) is considered the most accurate for diagnosis. It allows you to determine the thickness of the myocardium in each chamber, the size of the cavities, the presence of dilatation.
Enlarged Heart Treatment
When this symptom is identified, patients ask themselves what to do if the heart is enlarged. Treatment should be started only after a full examination and clarification of the reasons. If necessary, bronchodilator, antihypertensive, diuretic drugs are prescribed. In some cases, a combination of these agents is necessary. Regardless of the reason, it is important to take medications that affect the suppression of heart failure. These include the preparations “Coronal”, “Propronalol”, “Captopril”, etc. In case of severe heart defects, surgical treatment is necessary. It is also prescribed for persistent ischemia and acute circulatory failure.
Enlarged heart
Unfortunately, heart failure rarely goes away completely, as it is a chronic progressive disease. With inadequate therapy or its absence, the consequences can be serious. In the case of severe cardiomegaly, the patient constantly does not have enough air, as a result of which all organs suffer. Also, the disease can lead to myocardial infarction, stroke, thromboembolism of the heart or pulmonary vessels.