Cardiomegaly, or an enlarged heart, is an indicator of a condition that puts a strain on your heart. Your healthcare provider can use imaging to measure your heart’s size, but they’ll want to find the cause of your enlarged heart. Treatment depends on what’s causing your enlarged heart. You may need medicine, a procedure or surgery.
An enlarged heart (cardiomegaly) describes a heart that’s bigger than what is typical. Your heart may be unusually thick or dilated (stretched). An enlarged heart may be temporary or permanent, depending on the cause. Cardiomegaly can happen to your whole heart or just parts of it.
Heart enlargement can be your heart’s reaction to something that forces it to use more effort to circulate blood. It’s like walking uphill all the time instead of on level ground. In some cases, your heart becomes enlarged due to an underlying problem with the heart itself.
You have a higher risk of developing cardiomegaly if you have:
Coronary artery disease, the most common cause of cardiomegaly, happens to many people. It affects an estimated 18 million people aged 20 and older in the United States. Congestive heart failure, which is often caused by a dilated heart, is the leading cause of hospitalization over the age of 65 in the United States.
Yes, cardiomegaly can be serious. It depends on the condition that’s causing it. Some of these conditions are chronic. That means they last a long time and require treatment for many years.
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In some people, an enlarged heart doesn’t cause any symptoms. Other people with an enlarged heart might experience:
Any disease that makes your heart work harder can enlarge it. Just like your arm or leg muscles get bigger when you work out, your heart gets bigger when it has to work harder. However, unlike your arm or leg muscles, your heart doesn’t always become more effective just because it gets bigger.
Many disease processes can cause the heart to dilate due to problems with the underlying heart muscle. In these cases, despite the heart being bigger, its function actually worsens.
The most common cause of an enlarged heart is coronary artery disease (which can lead to a heart attack).
Other enlarged heart causes include:
In some cases, elite athletes will develop an enlarged heart just due to repeated exertion. In this case, the heart’s function will be normal (or even better than normal) despite the enlargement.
A diagnosis starts with discussing your symptoms and family health history. They’ll ask you about your exercise history. Your healthcare provider may hear a heart murmur when they listen to your heart with a stethoscope. You may have other signs of heart failure, including leg swelling, crackles in the lungs due to fluid, or engorged neck veins due to extra fluid in the body as the heart can’t pump efficiently. They may order tests to assess your cardiomegaly and rule out other conditions.
Some common tests include:
Enlarged heart treatment focuses on managing the condition that’s causing cardiomegaly. Your healthcare provider may prescribe medications to treat any underlying heart conditions.
Lifestyle changes include:
Common heart medications include:
Enlarged heart treatment may include procedures/surgery to:
Any medication can cause side effects, but many of these get better or go away with time. Contact your healthcare provider if the medicine they prescribed for you is causing issues. They can replace it with a different drug.
Surgeries carry a risk of bleeding or infection, along with other risks that vary by procedure. If you’re concerned about these and other risks, talk to your provider about what safeguards are in place to protect you.
If you have a family history of cardiomegaly, ask your healthcare provider what you can do to manage your risks. You may also make some lifestyle changes, such as:
Many people effectively manage the symptoms of an enlarged heart. The earlier you receive care, the better your chances for a positive outcome. Early cardiomegaly treatment can stop the condition from getting worse.
The health risks of an enlarged heart depend on the cause. They also depend on which part of your heart is enlarged.
Potential health complications from an enlarged heart can include:
Some people have an enlarged heart because of temporary factors, such as pregnancy or an infection. In these cases, your heart will return to its usual size after treatment.
If a chronic (ongoing) condition is causing your enlarged heart, it usually won’t go away. You need to continue medication or other treatments to manage symptoms.
Follow your healthcare provider’s instructions for managing the condition that caused your cardiomegaly. This could mean making lifestyle changes, taking medicine or having a minimally invasive procedure.
Keep going to your regular checkups with your provider so they can monitor your condition. Seeing them regularly allows them to check to be sure you aren’t developing worse symptoms or complications. If you develop symptoms like leg swelling, shortness of breath or chest pain, it could indicate cardiomegaly. In this case, you should see your healthcare provider right away.
Most of the time, an enlarged heart isn’t an emergency. Seek immediate medical attention if you experience:
A note from Cleveland Clinic
Though an enlarged heart may not go away, most people are able to manage the condition well with the right treatment. Don’t be afraid to ask your healthcare provider questions about what’s causing your enlarged heart. Understanding what’s happening in your body is the first step in managing your condition. Be sure to keep taking medicines your provider prescribed for you and keep going to all scheduled appointments.
Last reviewed by a Cleveland Clinic medical professional on 07/10/2022.
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