### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
hi i recently had to have a echo done on my heart because it was enlarged should i be worried? i stay tired all of the time also but they put me on vitiam d to take because it was low. also suppose to be getting a surgery done soon for a colonocoptcy and the part where they go down your throat also in same day is that a bad procedure and are you out im kinsda scared

### output:

Hello! Thank you for contacting on Chat Doctor! Regarding your concern, I would explain that an enlarged heart (ventricle(s)); that is a dilated cardiomyopathy, may be a final natural conclusion of several pathological processes involving the heart (valvular, ischemic, myocardial, infectious, etc. disorders). When dealing with the evaluation of a dilated cardiomyopathy, the two main issues to consider are: (1) severity of cardiac function impairment in terms of abnormal LV ejection fraction lowering, and adverse ventricular myocardial remodeling, and (2) persistence of etiological factor and its triggered pathological processes. The main goal to achieve in a dilated cardiomyopathy are:(a) To completely relieve (if possible) the etiological triggering factor, (b) Impede as much as possible pathological myocardial remodeling, thus stopping further dilation, (c) Preventing potential cardiac and systemic complications derived by dilated cardiomyopathy (clinical signs and symptoms of heart failure, like congestion, excess fatigue, several arrhythmias, etc.). Facing your actual condition, you need to discuss with your cardiologist about possible triggering factors of actual cardiomyopathy (in order to avoid them)., and to implement an ongoing therapy as you demonstrate heart failure symptomatology (fatigue, etc.). Regarding the interventional digestive procedure, I would explain that though you have a dilated cardiomyopathy, there are no contraindications for colonoscopy, as far as you have implemented an appropriate management strategy for heart failure. These diagnostic procedures AR performed through a light sedation, which is not harmful for the heart. So I recommend discussing with your cardiologist about the above-mentioned issues. Hope to have been helpful! Greetings! 