Enlarged Heart Symptoms

High blood pressure or coronary artery disease are the usual causes.
Congestive heart failure may be a result of poor blood flow. It may improve over time. But, in the main,  people with an enlarged heart need life-long treatment together with medications.

The heart enlarges because of damage to the heart muscle. It is still possible for an enlarged heart to pump blood normally. As the condition progresses,  the heart‘s pumping ability reduces. The main type of enlarged heart is Dilated cardiomyopathy. The heart walls  (also known as ventricles) become thin and stretched. This enlarges your heart.In other types, the muscular left ventricle becomes very thick. High blood pressure may cause your left ventricle to enlarge (a type known as hypertrophy). The thickening (which doctors call hypertrophic cardiomyopathy) can also be inherited.

An enlarged heart keeps more of its pumping ability when it’s “thick” rather than “thin.”


Blockages are the most common trigger that affect the heart’s blood supply (coronary artery disease) and high blood pressure. There can be other causes, including:

Idiopathic dilated cardiomyopathy is where a specific cause can not be identified.


Most often, an enlarged heart causes no symptoms. If it becomes unable to pump blood well enough, you may get symptoms of congestive heart failure, such as:

  • Shortness of breath (especially when active or when lying flat)
  • Leg swelling
  • Weight gain, particularly in your midsection
  • Tired feeling
  • Palpitations or skipped heartbeats

Many never have symptoms. Others may have minor issues that don’t change for years.  Some  may have shortness of breath that steadily gets worse.


An enlarged heart may be discovered after you and your doctor talk about symptoms you have that could be tied to congestive heart failure. Other times, it’s discovered from a test for something else.

An ultrasound of your heart — you may hear it called an echocardiogram — is the best way to diagnose it. There’s no pain or risk from it. It measures the heart’s:

  • Size
  • Muscle thickness
  • Pumping function

In some cases, it can help your doctor figure out what’s causing your enlarged heart.

Other things can help discover an enlarged heart, such as:

Your history: Shortness of breath or other symptoms of congestive heart failure may provide clues.

A physical exam: You may have swelling. An enlarged heart can also produce abnormal sounds when a doctor listens with a stethoscope.

Chest X-ray: Dilated cardiomyopathy increases the heart’s size on a chest X-ray film.

Cardiac catheterization : This looks for blockages in the coronary arteries. The heart’s size and pumping function can also be checked.

Blood tests: These may be done to check for things that can lead to enlarged heart, such as:

CT scans and MRIs: These may help diagnose an enlarged heart in certain situations.

Biopsy : Very rarely, a doctor may ask for a small tissue sample from inside the heart to determine the cause of an enlarged heart.