Check Carefully: Which Types of Enlarged Heart Are Dangerous? Revealing Causes That May Not Always Indicate Disease

If a health check reveals an enlarged heart, don't rush to worry. Get to know"non-disease enlarged heart"and"disease-related enlarged heart."Also, check for symptoms of easy fatigue and ways to prevent cardiomyopathy.

Many people may be alarmed when their chest X-ray results indicatean "enlarged heart".But did you know that a large heart shadow doesn't always mean disease? Let's clarify which types of enlarged heart signal dangerous cardiomyopathy and which result from breathing behavior or posture during X-rays.

"Enlarged heart"What is it, and why is it sometimes detected without disease?

Medically, enlarged heart conditions are divided into two main groups: disease-related and non-disease. Most cases seen on chest X-rays showing a larger-than-normal heart shadow are caused by three external factors:

1. Diaphragm pushing the heart: Normally, the heart moves with the diaphragm. If the X-ray is taken during exhalation, the diaphragm moves upward, causing the heart toshift sideways,making the heart shadow appear larger (unlike during inhalation when the diaphragm contracts downward, allowing the heart to expand normally).
2. X-ray positioning: Taking images from front to back can make the heart shadow appear larger than when taken from back to front.
3. Other physiological factors: Such as fat deposits around the heart, which may enlarge the heart shadow and require confirmation by echocardiogram.

Disease-related enlarged heart: warning signs not to ignore

In cases where the enlarged heart is due to disease pathology, it is often caused by cardiomyopathy or fluid in the pericardium. Three main diseases are key causes:

• Hypertension
• Ischemic heart disease
• Valve abnormalities

Symptoms of enlarged heart to watch for

Patients may have no symptoms at first and are diagnosed incidentally, but if symptoms worsen, they will feel"easily fatigued upon exertion,"such as becoming tired walking at home, bathing, or talking. Severe cases may prevent normal daily activities or sleep.

Complications and prevention

If left undiagnosed and untreated, enlarged heart may lead to severe cardiomyopathy causing"pulmonary edema"and"shock,"which can be life-threatening.

Best ways to prevent enlarged heart

Enlarged heart from cardiomyopathy often results from comorbidities such as diabetes, hypertension, and coronary artery disease. The best prevention is lifestyle modification, including:

• controlling diet and blood sugar levels,
• exercising regularly,
• maintaining stable blood pressure and cholesterol,
• taking medications as prescribed and attending all follow-up appointments.

An enlarged heart is not as frightening as thought if we understand the true causes. An enlarged heart shadow on X-ray may be due to scanning technique or body anatomy. But if accompanied by breathlessness, seeing a doctor for a thorough check is the best way to prevent future risks.

Source: Dr. Bandit Naratrikun, Cardiology Division, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University