Cardiomegaly is the term pathology of a very enlarged heart. Cardiomegaly can be the whole organ of the heart, or a separate part of it.
Do not confuse cardiac muscle hypertrophy with cardiomegaly. When hypertrophy of the myocardial wall thickens, it is not observed in the cardiomegaly.
An enlarged heart is detected only during radiographs or preventive measures in fluorography.
Very often, an enlarged heart is not made known by bright symptoms. The asymptomatic course of the disease leads to the advanced form of cardiomegaly.
This pathology is almost never detected in the initial stage of the disease.
The pathology of an enlarged heart requires a more detailed study in cardiology.
Modeling conditions of cardiomegaly
Radiologists know that not all shadows during an x-ray in the heart area mean that the heart is enlarged.
The shadow index on the X-ray image can be:
“Straight back” syndrome – This is a pathology in the physiological structure of the human skeleton, when the patient has formed a flat thorax and there is no curve in the spine.
The images from the side provide the opportunity to see and measure the distance from the chest to the eighth spine.
If, while measuring, the distance is 11.0 centimeters and less in men and in women less than 9.0 centimeters, then the cardiomegaly sign is false.
The presence of fluid in the pericardium. Gives a visible shadow in roentgen. This pathology is observed in case of pericardial disease, a traumatic condition of the thorax, a decrease in the effectiveness of the thyroid gland and swelling in the body.
Lots of fat on top of the heart organ. casts shadows on x-rays.
Pathology that has an innate nature. – This is the absence of the pericardial layer. With this pathology, the shadow of the heart in the X-ray image shifts to the left.
Pleuritis – This is the presence of fluid in the pleura, as well as lesions of the ribs and pleural laminae.
For a complete diagnosis, the radiography is performed in the prone position. The results of this study are more precise, because the liquid does not interfere with high quality X-rays.
With obesity and large abdominal volume.. With larger forms, the diaphragm moves upwards, which in the radiography can project a shadow, as with an enlarged heart.
The diagnostic methods of cardiomegaly allow to recognize the true pathology.
This pathology is associated more often with such diseases of the body:
- Hypertension – Myocardial shift, which is caused by high rates of blood pressure (blood pressure), for a long time. The pathology is manifested by left ventricular hypertrophy. It is possible to confirm hypertrophy by ultrasound of the heart and using an ECG (electrocardiography)
- Congenital and acquired heart disease. – there are noises in the organ of the heart during the defect, during the diagnostic test there are violations in the functionality of the valves and their structure
- Cardiac ischemia – It manifests in angina pectoris and poor fluidity in the arteries.
- Cardiomyopathy – Highlighted in viral infections, as well as chronic dependence on nicotine and alcohol.
An increase in heart volume does not have to be due to heart disease In a professional athlete, an enlarged heart is a sign of his professional activity, due to an increase in total body weight.
Such a trained heart is capable, with high loads in the body, of providing the entire blood flow system with a biological fluid. Strength sports athlete, increased heart muscle. and much stronger than the average person.
Do you know the structure of the heart muscle?
In addition, people with a hyperestrictive body have a larger heart. But it is necessary to distinguish people who are obese and those who have a greater body mass, due to muscle tissue.
Cardiomegaly caused by abnormalities in the vascular system.
This pathology is caused by a hypertensive disease and a malfunction of the heart valves. The hypertrophy of the heart muscle is caused by hemodynamic disorders within the organ of the heart, which is caused by abnormalities in the functioning of the myocardial valves and their structure.
In addition, in case of hypertension, increases the arterial resistance, in which the cardiac muscle makes a maximum effort to push the blood in the desired direction.
This constant tension of the heart muscle and causes the development of cardiomegaly in all the chambers of the human organ.
Also the cardiomegaly triggers can be viral and infectious myocarditis, as well as cardiomyopathy.
The cadyomyopathy develops on the basis of the chronic stage of alcohol dependence, as well as on the effect on the myocardium of certain hormonal drugs in the treatment of thyroid disease and adrenal diseases.
In addition to cardiac pathologies, cardiomegaly is caused by diseases that are no less complex and dangerous than heart diseases.
Diabetes is a pathology that affects the functionality of the vascular system and the heart muscle.
In diabetes, abnormalities occur in the metabolic process of the body and inadequate degradation of proteins., In addition to fat, it leads to the fact that it affects the state of the myocardium and the coronary vessels.
The deposition of cholesterol plaques in coronary vessels causes a violation of blood flow, increasing the level of glucose in the blood. As a result of this action, hypertrophy of the myocardial chambers and cardiomegaly may occur.
Provocateur of cardiomegaly can be anemia, which is caused by malnutrition, hunger in obesity. This leads to an altered cardiac function, which leads to changes in the myocardial tissue and an increase in the chambers of the heart.
Diseases of the cardiovascular system.
Cardiomegaly with ischemia of the heart.
Cardiomegaly is not associated with symptomatic myocardial ischemia and is not a sign of it. But the consequences of an acute form of heart attack, as well as repeated attacks of angina, lead to an increase in the organs.
Attacks with stable cardiac angina cause physical activity and unstable angina occurs without cause. Attacks with unstable angina become frequent and even in a relaxed state.
The duration of the attacks can exceed half an hour. The heart muscle over a long period of time is in a state of increased cardiac stress.
When expanded, these deposits close the lumen of the artery, which prevents normal blood flow.
Atherosclerosis of the heart and arteries also leads to hypertrophy of the heart cavities.
This pathology of the arteries, within which cholesterol plaques form.
The consequence of this deviation in the bloodstream is not the correct work of the myocardium, the insufficient supply of blood to the internal organs, the brain.
Complicated sclerosis is a progressive disease: cardiosclerosis, angina pectoris, heart attack and stroke.
Aneurysm of the coronary arteries and left ventricle: the pathology occurs against defects in the walls of the arteries, as well as in the walls of the left ventricle of the cardiac organ.
Bradycardia is formed at the bottom of a complicated form of aneurysm, due to disturbances in hemodynamics and pathology in the mitral and aortic valve. Complications in the mitral valve have an irreversible form of development and do not disappear after the removal of the aneurysm.
- Pain below the ribs, which is transmitted to the left side of the body: arm, neck on the left side and left side of the jaw
- Duration of pain less than 15 minutes.
- The pain is relieved with nitroglycerin.
Why does the size of the fetus’ heart increase? An enlarged heart during intrauterine development is a dangerous pathology that is very difficult to cure.
Cardiomegaly can develop from the influence of external factors in a woman at the time of pregnancy, precisely at the moment when the intrauterine formation of the organ of the heart and the system of the blood arteries takes place.
The marker of the fetal heart system occurs very early, on day 17 of the pregnancy calendar. By the end of the first trimester, a 4-chamber heart and the entire blood flow system have already been formed.
Risk factors for cardiomegaly formation:
- Radiation of x-rays
- Virus in the body of a pregnant woman: the flu, the herpes virus
Nicotine addiction of the mother.
- Take narcotic drugs before pregnancy and during fetal development.
- Receiving medications from a category of barbiturates.
- Modern diet that depletes the body.
It is also very important to take into account the genetic predisposition of the child, through the mother.
In children, a heart disease and Ebstein’s disease are formed before birth. These pathologies lead to a moderate form of cardiomegaly.
If there are no obvious reasons for the development of this pathology, this form of cardiomegaly is called idiopathic.
The Ebstein anomaly
Symptomatology when the newborn’s heart enlarges:
- Cyanosis of the trunk or face only
- Shortness of breath while crying
- Dyspnea during the suction process.
- Tachycardia in pronounced form.
For a diagnostic test of the heart organ of a newborn baby, x-ray examinations and ultrasound machines are performed.
50.0% of children with congenital cardiomegaly die shortly after birth, the rest of the children have cardiac pathologies in which to live.
Enlarged baby’s heart
Cardiomegaly in a child is a congenital pathology. The pathology of Ebstein develops in the uterus, which causes cardiomegaly:
- Violation of the tricuspid valve on the right side of the atrioventricular passage of biological fluid
- The hole between the atria does not grow too much
- The right ventricle is smaller than the standard figure.
In Ebstein’s pathology, the heart organ increases twice its size. Blood clots are diagnosed in the chambers of the heart.
Symptoms of cardiomegaly in a child:
Arrhythmic and superficial respiration.
- Cyanosis of nose and mouth.
- Pale skin
- Increased sweating
- Pronounced tachycardia
- Swelling of the face and extremities.
The diagnostic study of the disease does not differ from the diagnosis of an adult organism, and the treatment of a child is the same as that of an adult.
There is no pronounced symptomatology of cardiomegaly.
The symptoms depend on the pathology that became the cause of this disease. and manifests itself only with greater stress in the body:
- Fatigue occurs after physical exertion on the body, which causes difficulty in breathing, a sharp headache and a circle in the head, which can turn into nausea. This symptom develops at the heart of heart failure.
- The increase in heart rate after exercise indicates the first signs of pathology in the myocardium. If a heart rate increases without an apparent reason, then it is a sign of the development of deficiency and heart attack.
- Pain behind the chest The rapes are manifested by squeezing pain after exercise.
- Swelling of the lower limbs. The development of this symptom also occurs due to heart failure, as well as failure of the blood flow system.
- Gravity in the left hypochondrium.
- Enlarged arteries in the neck.
With such symptoms, it is necessary to go urgently to a cardiologist and undergo a diagnostic review of the organ, since the symptoms of cardiomegaly are very similar to the symptoms of fatal myocardial diseases.
It is necessary to begin the study of heart cardiomegaly by examining a patient, identifying open signs, listening to the sounds and sounds of the heart, as well as an accurate study of the pathology. You need to go through a series of laboratory and instrumental procedures:
- Blood and urine in general.
- Blood for hormonal analysis.
- Blood for rheumatism.
Bacterial sowing for the detection of infectious bacteria.
- Ultrasound of the heart
- Ecg (electrocardiography)
- Biochemical analysis
- Blood tests for cholesterol detection
- Bone scan
- Coronary angiography
- Catheterization of myocardium cameras.
OAK identifies abnormalities in the composition of the blood and also shows the platelet blood index, leukocyte molecules, erythrocyte index and hemoglobin index.
Heart ultrasound captures the pathology in each chamber of the heart, as well as the functioning of the heart’s chambers and valves.
Electrocardiography is an instrumental examination of the heart and arteries. This method is determined by sealing the walls of the myocardium chambers.
The radiography allows, when diagnosing, to determine the limits of the cardiac muscle, the size of the myocardium in the longitudinal and transversal projection.
Calculate the size of the proportion of the sternum shadow that can identify myocardial pathology. Give a conclusion about the possible size of the heart.
In addition, X-rays reveal the pathology of the aorta, pulmonary artery.
Coronary angiography reveals atherosclerotic accumulations in the walls of the coronary arteries and arterial permeability.
MRI (magnetic resonance imaging) will allow you to fully explore the walls of the arteries, the mitral valve and the myocardium.
X-ray of cardiomegaly (right) and normal heart (left)
Size of the heart organ
The size of the organ of the heart according to the study by the ultrasound method – regulatory indicators of the parameters of the left and right ventricles:
- The left ventricular mass index is 135.0 – 182 grams (men), 95.0 – 141.0 grams (women)
- Diastole volume: 65.0 – 193.0 (men), 59.0 – 136.0 for the female body
- The thickness of the myocardial wall LJ (left ventricular) with systole – 1.1 cm, if the figure reaches 1.60 cm, left ventricular hypertrophy has developed
- Blood ejection fraction not lower than 55.0 – 60.0%
- Volume of shock fluid – 60.0 – 100.0 milliliters
- The normative units of the right ventricle correspond to: a wall of 5 millimeters thick, index of size of pj: 1,750 – 1,250 square centimeters for systole and 0.750 – 1.10 for diastole.
Treatment and Prevention
In the treatment of cardiomegaly, it must always be remembered that this pathology is not completely cured and that it is possible to maintain the myocardium and the patient’s condition only with one method of therapy. With such therapy, the main thing is to provide preventive measures for the development of heart failure.
- Take medicines from the nitrate group: nitroglycerin
- Using blockers (beta)
- APF inhibitors
- Diuretic use
- Acceptance of cardiac glycosides.
It is also very important to observe the culture of nutrition behavior and culture:
- Do not physically load the body.
- Give up smoking
- Do not drink alcohol
Observe the correct way of the day.
- Ensure a good sleep
- Avoid the nervous surge
- Low fat diet (cholesterol)
- Do not overeat, because overeating increases body weight and obesity is an increase in the heart.
- The use of salt is reduced to a minimum.
- Eat more fresh vegetables, vegetables and fruits.
- Drink less liquids
In addition, the treatment method of cardiomegaly is a surgery (organ transplant).
It is very difficult to treat this pathology, because the etiology of this disease has not been fully investigated.
Prognosis for cardiomegaly.
The prognosis depends on the nature of the pathology, as well as the degree of negligence and the consequences. Heart failure in the myocardium has the properties of a rapid progression to a more severe degree, which is plagued by a fatal infarction.
The progression of heart disease gives a prognosis for life of only two or three years. In patients who have undergone surgery and have no defect or insufficiency, the prognosis is favorable, with adequate medical support for the myocardium.
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