In their practice, doctors often encounter people with heart disease. More often this applies to patients of elderly or senile age. In some cases, heart pathologies are also found in the working population. Newborn babies 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 cardiac diseases. An increase in the heart muscle usually indicates a long-term pathology that led to CHF.
Cardiomegaly - what is it?
Normally, the size of the heart is individual for everyone. 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 hand clenched into a fist. Nevertheless, there are limits separating the norm from the pathology. An enlarged heart is called cardiomegaly. It can be detected both during a physical examination and through instrumental diagnostics. In most cases, the ventricle of the heart is enlarged, mainlyleft. Less often, 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 (dilation). This phenomenon rarely occurs in the short term. Cardiomegaly is usually preceded by a long-term chronic illness.
Enlarged heart: causes of pathology
Cardiomegaly can occur due to many reasons. It depends on the age of the patient, hereditary predisposition, body weight and lifestyle. Sometimes an enlarged heart is considered a variant of the norm. In this case, cardiomegaly should be moderate. Such cases include constant physical activity, pregnancy, rarely adolescence. A significant increase in the size of the heart in this category of people is also a pathology. The following causes of cardiomegaly are distinguished:
- Birth defects (CHF). They are formed during pregnancy, can be of various sizes. With large or combined defects, heart failure occurs quickly. In this case, cardiomegaly can manifest itself already in the first months of a child's life. If the defects are minor, 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 become chronic. Dilated myopathy can also be attributed to this group.
- Acquired heart defects. Formed in adulthood. Most often they are a consequence of rheumatism.
- Chronic cardiovascular pathologies. These include myocardial ischemia (heart attack, angina pectoris), arterial hypertension.
- Chronic lung diseases. Among them are bronchial asthma, COPD.
- Pathologies of other organs and systems. Enlargement of the heart can be observed with severe anemia, kidney and liver failure, hyperthyroidism.
- Metabolic syndrome (obesity combined with diabetes).
Mechanism of development of cardiomegaly
The pathogenesis of cardiomegaly depends on the cause. Most often, left ventricular hypertrophy occurs in people who have metabolic syndrome, coronary artery disease, or arterial hypertension. With a low supply of oxygen, the heart muscle contracts more than usual, and gradually increases in size. The same thing happens with hypertension. In this case, the heart does not have time to pump blood fast enough due to its high pressure, so the body needs more effort. The mechanism of development of cardiomegaly differs in 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 sections 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 whenenlarged heart
Symptoms of an enlarged heart can be expressed in varying degrees. With left ventricular hypertrophy, patients complain of shortness of breath. Attacks of lack of air occur during exercise, heavy lifting, fast and long walking. With severe cardiomegaly, shortness of breath can be at rest. In addition, some patients present with edematous syndrome. Most often, fluid accumulates on the lower third of the legs in the evening. If the cause of CHF is ischemia, patients are concerned about pain in the cardiac region. Also, the clinical picture depends on the cause of cardiomegaly. With pulmonary pathologies, coughing and suffocation are added to the listed symptoms. Liver failure is characterized by massive edema (ascites, anasarca), swelling of the cervical veins. Older people with an enlarged heart often have hypertension.
How to diagnose cardiomegaly?
There is not enough history to detect cardiomegaly. For this, it is necessary to carry out palpation and percussion of the organ. When the heart is tapped, it becomes clear to the doctor whether its size is normal or goes beyond its boundaries. In addition, a chest X-ray is performed. With cardiomegaly, the outline of the organ in the pictures is enlarged. To determine in which departments hypertrophy is observed, an ECG is performed. Thanks to this study, you 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 allowsdetermine the thickness of the myocardium in each chamber, the size of the cavities, the presence of dilatation.
Treatment of Enlarged Heart
When this symptom is detected, patients are wondering what to do if the heart is enlarged. Treatment should be started only after a complete examination and clarification of the causes. If necessary, bronchodilators, antihypertensives, diuretics are prescribed. In some cases, a combination of these agents is needed. Regardless of the cause, it is important to take medications that affect the suppression of heart failure. These include drugs "Coronal", "Propronolol", "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: consequences of the disease
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 lacks 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.
