The best way for a physician to evaluate cardiac enlargement is with an echocardiogram. This test uses a form of ultrasound similar to that used to look at gallbladders, kidneys, and pregnant women’s babies. Using a sophisticated computer and monitor and a small plastic probe and some gel placed on the chest, the echocardiogram can directly show the size and thickness of the heart muscle in each chamber. It can also gauge heart function, an important piece on information when deciding how to treat the enlargement.
Is treatment for cardiac enlargement necessary? Is the condition permanent?
Because any of the forms of cardiac enlargement will result in an increased risk of death and decreased quality of life for most patients, treatment is strongly recommended. Treatment may slow or reverse the disease process and help symptoms, if they are present. When cardiac enlargement is diagnosed early, treatment is recommended even before symptoms start.
Unfortunately, in cases of cardiac dilation, whatever damage has been done is usually permanent; treatment will focus on improving heart function, in spite of the damage. In some cases of hypertrophy, however, at least some of the muscular thickening can be reversed by the use of beta-blocker medication. In addition, the calcium channel blocker verapamil has been shown to improve prognosis for those with hypertrophy by directly relaxing the heart muscle.
What is the treatment for cardiac enlargement?
For patients with cardiac enlargement, all underlying causes – such as high blood pressure, hemochromatosis, thyroid problems, pulmonary blood clots, sleep apnea, emphysema, chronic bronchitis, lupus or other inflammatory disease – should be treated as completely as possible. This will decrease the chance of ongoing damage to the heart. Metal exposure or alcohol or cocaine use should be controlled or eliminated, when applicable. If medications for HIV or schizophrenia are a factor, risks and benefits of continuing or changing medications should be considered. Luckily, there are alternative medications in many cases. Those with valvular heart disease should have their condition treated with medication. Depending on a variety of factors, heart valve replacement or repair – either through “open heart” surgery or with a catheter entering the heart through a blood vessel at the groin, in a procedure similar to that used for a coronary angiogram – may be recommended.
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