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Cardiomegaly: what it is, signs, how to treat
Last reviewed: 04.07.2025
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Today, cardiovascular diseases occupy one of the leading positions among all pathological processes. Cardiomegaly or “bull’s heart” is characterized by pronounced changes in the shape, volume and size of the heart muscle, as a result of which the process of blood pumping is disrupted. This pathology is not an independent disease, but develops against the background of other diseases of cardiac activity. Cardiomegaly can be both congenital and acquired, therefore it occurs equally often at any age.
Causes cardiomegaly
An increase in the size of the heart can be a consequence of both pathological and physiological changes. Natural processes include an enlarged heart in athletes, due to heavy loads the heart muscle has to pump large volumes of blood, as a result of which an increase in muscle fibers occurs. As for pathological changes, they include the following reasons, the impact of which can lead to the development of cardiomegaly:
- persistent increase in blood pressure;
- insufficient oxygen supply to the heart muscle;
- congenital and acquired malformations of the structure of the heart muscle;
- myocarditis;
- pneumosclerosis;
- pulmonary emphysema;
- myocardial infarction.
Risk factors
Factors that contribute to the development of cardiomegaly include:
- viral and infectious diseases;
- use of necrotic drugs;
- alcohol abuse;
- smoking;
- genetic predisposition;
- labor, the period of bearing a fetus;
- chronic anemia;
- aggravated allergic history;
- endocrine system diseases;
- chronic stress;
- renal apparatus damage;
- working with toxic substances.
Symptoms cardiomegaly
An accurate diagnosis is formulated not only on the basis of the examinations performed, but also on the complaints presented by the patient. Cardiomegaly often develops against the background of other pathologies of the cardiovascular system, so most often there are no specific symptoms on the basis of which an accurate diagnosis can be made.
First signs
The first thing you need to pay attention to when suspecting the development of heart disease is the presence of shortness of breath, swelling, pain in the heart area and the development of arrhythmia itself.
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Cardiomegaly in the fetus and newborns
Cardiomegaly can be a congenital pathology of the heart muscle, which can be detected during the first routine ultrasound screening. This condition is quite dangerous primarily for the child and for the mother as well. In almost every third case, the pregnancy ends in termination. Fetal cardiomegaly develops under the influence of negative factors on the pregnant woman in the first trimester, the period of laying all organs and systems.
Congenital heart defects may manifest themselves in the first few days after birth, or they may remain latent until the first signs appear at an older age. Cardiomegaly in newborns manifests itself as severe lethargy, rapid fatigue, anxiety, refusal to breastfeed, and oral cyanosis.
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Cardiomegaly in children
In children of all age groups, cardiomegaly is formed in the case of previously undiagnosed congenital or acquired heart defects. At this age, the pathological process manifests itself in the form of: rapid fatigue, decreased attention, endurance, sleep disturbances, lack of appetite, neurological disorders and psychoemotional lability.
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Stages
Moderate degree of cardiomegaly
Most often, the myocardium of the left ventricle of the heart is subject to pathological changes; normally, the wall thickness is 1–1.2 cm. Minor deviations from the norm are considered moderate.
- degree of cardiomegaly
The first stage of development of cardiomegaly begins with an increase in the myocardial wall within the range of 1.2 cm to 1.5 cm.
- degree of cardiomegaly
The second degree corresponds to an increase in wall thickness from 1.5 cm to 2 cm.
- degree of cardiomegaly
The third degree of development of the pathological condition corresponds to an increase in the wall to 2 cm and higher.
Forms
The types of cardiomegaly depend on the initial cause against which the pathological process developed.
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Complications and consequences
Enlargement of the heart muscle can lead to the development of a number of other complications and pathologies, in addition to the one that is the initial cause of the development of cardiomegaly. With excessive enlargement of the heart, some parts of the myocardium are exposed to greater pressure, which can subsequently lead to the development of complications such as ischemia, heart attack or stroke.
Diagnostics cardiomegaly
Diagnosis of this pathology, like any other disease of the cardiovascular system, is based on a series of laboratory and instrumental studies.
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Auscultation in cardiomegaly
When examining a patient with a phonendoscope, the doctor may note the expansion of the heart borders, muffled tones, weakening of the first tone at the apex, regurgitation noise and the appearance of a specific symptom, “gallop rhythm”. More specific data depend on the initial cause of the development of cardiomegaly.
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Tests
When cardiomegaly is detected for the first time, a comprehensive blood test is required, including serological, immunological and biochemical analysis.
Elevated levels of CPK and CPK-MB indicate the development of an acute process in the myocardium - myocardial infarction.
Elevated iron and transferrin levels are direct evidence of the development of dilated cardiomyopathy.
Necrosis factor, natural killer cells, specific circulating antibodies are markers of dilated cardiomyopathy
Instrumental diagnostics
ECG: ST-T changes, in some cases LV hypertrophy, pronounced Q wave in leads I, aVL, V5-6.
Echocardiography: dilation of the LV and RV, impaired contractility, asymmetric hypertrophy of the septum, and an increase in the thickness of the left ventricular septum itself are noted.
Cardiomegaly on radiograph
A conclusion about the development of cardiomegaly can be obtained by taking an X-ray in two projections, most often using direct and lateral. An increase in the LA is indicated by a doubled density of the X-ray shadow located along the right border of the heart and an increased level of the bronchus on the left side. An increase in the LV cavity is determined by a decrease in the intensity of the shadow of the entire heart directly on the anterior direct projection and by an increase in the contour of the LV. It is quite difficult to recognize an enlarged RA on an X-ray; in some cases, a decrease in the curvature of the silhouette is noted.
Transesophageal echocardiography: is an additional diagnostic method in cases where standard echocardiography has proven to be uninformative.
Stress ECHO-CT: a diagnostic method that allows determining the etiology of the development of a pathological process (ischemic or non-ischemic heart failure) and assessing the effectiveness of the treatment.
MRI (magnetic resonance imaging): allows you to accurately determine the weight of the heart, the thickness of the walls, the volume of the left ventricle, in addition, with the help of this diagnostic method it is possible to determine the thickening of the wall of the pericardium and the extent of areas of necrosis.
What do need to examine?
Differential diagnosis
Comparative diagnostics of cardiomegaly is carried out with constrictive pericarditis, atrial myxoma and Ebstein's anomaly.
Who to contact?
Treatment cardiomegaly
If signs of cardiomegaly are detected, the person must be immediately warned that irreversible processes are developing in the body, affecting the walls of the myocardium and the heart cavities. Therefore, the most effective treatment method in this situation is surgical intervention. But despite this, people suffering from this pathology must regularly maintain their condition with the help of drug therapy and follow all the recommendations of the attending physician, in particular, regarding a healthy lifestyle.
Drug therapy
Depending on the degree of development of the disease and the presence of concomitant pathology, a course of medications is prescribed, which most often includes:
- diuretics:
Furosemide: 40 mg per day.
Side effects: vomiting, nausea, dizziness, diarrhea, hypotension, redness, itching and swelling.
Contraindications: first trimester of pregnancy, breastfeeding, hypokalemia, renal coma, terminal renal failure.
- anticoagulants:
Warfarin: 2.5-3mg once daily
Side effects: bleeding, anemia, allergic reaction, diarrhea, vomiting, dizziness.
Contraindications: allergic reaction to substances included in the drug, predisposition to bleeding, cirrhosis, liver and kidney failure, malignant neoplasms, varicose veins of the esophagus, arterial hypertension.
- Beta blockers:
Anaprilin: from 10-15 mg to 100 (maximum dosage) per day (the higher the dosage, the more doses of 10-20 mg per dose)
Side effects: vomiting, nausea, dizziness, bradycardia, insomnia, severe pain in the back of the head and forehead, shortness of breath, cough, rashes in the form of hives, itching.
Contraindications: allergic reaction, angina pectoris, atrioventricular block, bronchial asthma, diabetes mellitus, colitis.
- angiotensin receptor blockers:
Losartan: up to 5 mg once daily
Side effects: nausea, possible vomiting, decreased blood pressure, hypercalcemia.
Contraindications: hypersensitivity to the components included in the drug, pregnancy and breastfeeding.
Cardiomegaly can develop against the background of vitamin deficiency, therefore one of the important components of drug therapy is the prescription of a vitamin complex, which must necessarily include vitamin B1.
Physiotherapy
Another important component of cardiomegaly treatment is physiotherapy procedures, which are recommended to be carried out both during the period of exacerbation and during the period of remission. The following methods are the most effective in the treatment of cardiomegaly:
- electrophoresis with anti-inflammatory drugs;
- UHF therapy;
- magnetic therapy;
- inhalation of steroid hormones;
- UHF therapy;
- radon or carbon dioxide baths;
- hypoxic therapy.
Contraindications to physiotherapy procedures:
- moderate and severe degree of development of cardiac pathology;
- heart failure;
- circulatory failure;
- arrhythmia.
Alternative medicine
In addition to drug therapy, many patients resort to old, proven recipes of traditional medicine; herbal infusions help strengthen the heart muscle and cleanse the vascular system.
Herbal decoction: to prepare the decoction you will need 20g of horsetail, 50-60g of hawthorn and 40g of knotweed, pour a glass of boiling water over the resulting mixture and let it brew for one hour. Take the infusion 20ml 6 times a day.
Rosemary tincture on red wine drink: 100g of rosemary leaves should be poured with 2l of red table wine, let it brew in a dark and dry place for 30 days. Take 20 ml 2-3 times a day, for up to 6-9 months.
Adonis: pour one tablespoon of dry, chopped herb with one glass of hot water, let it brew in a warm place, then strain and take 1-2 tablespoons 3-4 times a day.
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Recipes for treating cardiomegaly with folk remedies
Cranberry: a berry rich in vitamins, useful both fresh and dried. For heart disease, it is recommended to consume 1 tablespoon of berries ground with sugar 3-4 times a day.
Red beetroot: for congenital pathologies of the cardiovascular system, it is recommended to drink freshly squeezed red beetroot juice with one teaspoon of honey.
Garlic juice: to strengthen the walls of the heart muscle and blood vessels, it is recommended to take 6-7 drops of garlic juice and a teaspoon of olive oil in the morning on an empty stomach.
Homeopathy
Homeopathic medicines also occupy their niche in the treatment of cardiomegaly; the following are most often recommended:
Arsenicum album: the drug is used in a dosage of 3 to 30 divisions
Indications: cardiovascular diseases, gastrointestinal pathology, neuralgia, nephritis, bronchial asthma, pleurisy, pneumonia, eczema.
Side effects: diarrhea, nausea, vomiting.
Contraindications: renal failure, dyspepsia, neuritis.
Arnica: used in dosages from 3 to 30 divisions.
Indications: treatment of diseases of the cardiovascular system, nervous system.
Side effects: dizziness, nausea, vomiting.
Contraindications: individual sensitivity to the components included in the drug, pregnancy, breastfeeding, increased blood clotting.
Claronin: dosage 15 drops once a day.
Indications: coronary heart disease, angina pectoris, cardiosclerosis, cardiomegaly, myocarditis, pericarditis, vegetative-vascular dystonia, physical and mental overstrain.
Side effects: dizziness, nausea, vomiting.
Contraindications: none identified.
Surgical treatment
Surgical treatment of cardimegaly is the most effective of all treatment methods; today, experienced surgeons resort to such operations as:
- heart valve replacement surgery;
- coronary artery bypass grafting, performed in cases of progressive coronary heart disease;
- installation of pacemakers, the action of which is aimed at regulating the heartbeat;
- Installation of left ventricular assist devices is performed.
Prevention
Preventive measures are based on the elimination of all possible risk factors, the action of which can provoke the development of the pathological process: smoking, use of drugs and alcoholic beverages, constant stress, unfavorable living conditions.
In addition to the prevention of acquired cardiomegaly, it is necessary to carry out prevention of congenital pathology, which includes:
- registration at a women's clinic before the 12th week of pregnancy;
- early screening;
- giving up bad habits;
- vitamin therapy;
- compliance with doctor's recommendations.