Enlarged heart

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Causes

By Mayo Clinic staff

Sometimes, an enlarged heart develops for no apparent reason (idiopathic) but it can also be caused by a condition that can cause your heart to pump harder than usual. These conditions can include:

  • High blood pressure. Having high blood pressure can make it so that your heart has to pump harder to deliver blood to the rest of your body, enlarging the muscle.
  • Heart valve disease. Four valves within your heart keep blood flowing in the right direction. If the valves are damaged by such conditions as rheumatic fever, a heart defect, infections (infectious endocarditis), connective tissue disorders, certain medications or radiation treatments for cancer, your heart may enlarge.
  • Weakness of the heart muscle (cardiomyopathy). Cardiomyopathy is the thickening and stiffening of heart muscle. In early stages of cardiomyopathy, you may have no symptoms. As the condition worsens, your heart may enlarge to try to pump more blood to your body.
  • A heart condition you're born with (congenital heart defect). Many types of congenital heart defects may lead to an enlarged heart, as defects can affect blood flow through the heart, forcing it to pump harder.
  • Abnormal heartbeat (arrhythmia). If you have an arrhythmia, your heart may not pump blood as effectively as it would if your heart rhythm were normal. The extra work your heart has to do to pump blood to your body may cause it to enlarge.
  • High blood pressure in the artery connecting your heart and lungs (pulmonary hypertension). If you have pulmonary hypertension, your heart may need to pump harder to move blood between your lungs and your heart. As a result, the right side of your heart may enlarge.
  • Low red blood cell count (anemia). Anemia is a condition in which there aren't enough healthy red blood cells to carry adequate oxygen to your tissues. Left untreated, chronic anemia can lead to a rapid or irregular heartbeat. Your heart must pump more blood to make up for the lack of oxygen in the blood when you're anemic. Rarely, your heart can enlarge if you have anemia for a long time and you don't seek treatment.
  • Thyroid disorders. Both an underactive thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism) can lead to heart problems, including an enlarged heart.
  • Excessive iron in the body (hemochromatosis). Hemochromatosis is a disorder in which your body doesn't properly use iron, causing it to build up in various organs, including your heart muscle. This can cause an enlarged left ventricle due to weakening of the heart muscle.
  • Protein buildup in your heart (amyloidosis). Amyloidosis is a condition in which abnormal proteins circulate in the blood and may be deposited in the heart, interfering with your heart's function. If amyloid builds up in your heart, it can cause it to enlarge.
References
  1. Enlarged heart. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4517. Accessed Dec. 14, 2008.
  2. Samariel AM, et al. Molecular and cellular biology of the normal, hypertrophied, and failing heart. In: Fuster V, et al. Hurst's The Heart, 12th ed. New York, N.Y.: Mc-Graw Hill Professional; 2008. http://www.accessmedicine.com/content.aspx?aID=3049170&searchStr=cardiomegaly. Accessed Dec. 17, 2008.
  3. Hill JA, et al. Cardiac plasticity. New England Journal of Medicine. 2008;358:1370.
  4. Cardiomyopathy. National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/cm/cm_all.html. Accessed Jan. 28, 2009.
  5. Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 17, 2009.

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May 6, 2009

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