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Treatments and drugs
By Mayo Clinic staffTreatments for enlarged heart focus on correcting the underlying cause.
Medications
If cardiomyopathy or another type of heart condition is to blame for your enlarged heart, your doctor may recommend medications. These may include:
- Diuretics to lower the amount of sodium and water in your body, which can help lower the pressure in your arteries and heart, such as furosemide (Lasix), or other diuretics, such as spironolactone (Aldactone), which can help prevent further scarring of your heart tissue
- Angiotensin-converting enzyme (ACE) inhibitors to lower your blood pressure and improve your heart's pumping capability, such as enalapril (Vasotec), lisinopril (Zestril), ramipril (Altace) or captopril (Capoten)
- Angiotensin receptor blockers (ARBs), such as losartan (Cozaar) and valsartan (Diovan), for those who can't take ACE inhibitors
- Beta blockers to lower blood pressure and improve heart function, such as carvedilol (Coreg) and metoprolol (Lopressor)
- Digoxin, which can help improve the pumping function of your heart and lessen the need for hospitalization for heart failure
- Anticoagulants, such as warfarin (Coumadin), to reduce the risk of blood clots that could cause a heart attack or stroke
Medical procedures and surgeries
If medications aren't enough to treat your enlarged heart, medical procedures or surgery may be necessary.
- Medical devices to regulate your heartbeat. For people who have a certain type of enlarged heart (dilated cardiomyopathy), a special pacemaker that coordinates the contractions between the left and right ventricle (biventricular pacing) may be necessary. In people who may be at risk of serious arrhythmias, drug therapy or an implantable cardioverter-defibrillator (ICD) may be an option. ICDs are small devices — about the size of a pager — implanted in your chest to continuously monitor your heart rhythm and deliver electrical shocks when needed to control abnormal, rapid heartbeats. The devices can also work as pacemakers. If the main cause of your enlarged heart is due to atrial fibrillation, then you may need procedures to return your heart to regular rhythm or to keep your heart from beating too quickly.
- Heart valve surgery. If your enlarged heart is caused by a problem with one of your heart valves, you may have surgery to remove the narrow valve and replace it with either an artificial valve or a tissue valve from a pig, cow or human-cadaver donor. If you have valve regurgitation, in which blood leaks backward through your valve, the leaky valve may be surgically repaired or replaced.
- Coronary bypass surgery. If your enlarged heart is related to coronary artery disease, your doctor may recommend coronary artery bypass surgery.
- Left ventricular assist device (LVAD). If you have heart failure, you may need this implantable mechanical pump to help your weakened heart pump. You may have an LVAD implanted while you wait for a heart transplant or as a long-term treatment if you have heart failure and you're not a good candidate for a heart transplant.
- Heart transplant. If medications can't control your symptoms, a heart transplant may be a final option. Because of the shortage of donor hearts, even people who are critically ill may have a long wait before having a heart transplant.
References
- Enlarged heart. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4517. Accessed Dec. 9, 2010.
- Cardiomyopathies. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec07/ch084666/ch084666a.html. Accessed Dec. 9, 2010.
- What is cardiomyopathy? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/cm/cm_all.html. Accessed Dec. 9, 2010.
- Cardiomegaly on chest X-ray. In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05610-6..00065-2--s0020&isbn=978-0-323-05610-6&sid=1093880434&type=bookPage§ionEid=4-u1.0-B978-0-323-05610-6..00065-2--s0020&uniqId=229713866-3#4-u1.0-B978-0-323-05610-6..00065-2--s0020. Accessed Dec. 9, 2010.
- Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 3, 2011.
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