An enlarged heart (cardiomegaly) is a sign that the heart is overworked. Heart enlargement can be pathological (related to significant heart disease) or physiological (related to exercise or other physical activity). An enlarged heart is an indication of an underlying condition. If it is associated with heart disease, physicians will typically attempt to treat the underlying disease at the same time as the enlarged heart.

An enlarged heart is often present during heart failure, when the heart cannot pump adequate blood to meet the needs of the body. Additionally, a small number of patients have an enlarged heart with no known cause. An enlarged heart may be accompanied by symptoms such as shortness of breath (dyspnea), dizziness, swelling (edema) or irregular heart beat (arrhythmia).

Cardiomegaly may be discovered on an x-ray during an examination for an unrelated condition. Physicians can confirm the diagnosis by conducting an echocardiogram (a test that uses sound waves to evaluate the heart’s anatomy and function).

Treatment for an enlarged heart can include medications (e.g., ACE inhibitors and beta blockers) to treat the condition itself, as well as treatment for any underlying conditions, such as high blood pressure or heart valve disorders. With proper treatment, the condition may be controlled or even reversed, although the underlying disease may be difficult to control.