page_title: Cardiomegaly
section_title: Diagnosis
hierarchical_section_title: Cardiomegaly / Diagnosis
caption_attribution_description: English: Histopathology of (a) normal myocardium and (b) myocardial hypertrophy. Scale bar indicates 50 μm.- a) Young accident case (23-year-old male). Myocardial structure is maintained without pathology.- b) Hypertrophic heart failure case (46-year-old male). Hypertrophic myocytes with enlarged nuclei are regularly arrayed with slight interstitial fibrosis.
context_page_description: Cardiomegaly is a medical condition in which the heart is enlarged. As such, it is more commonly referred to simply as "having an enlarged heart".
  Cardiomegaly is not a disease, but rather a condition that can result from a host of other diseases such as obesity or coronary artery disease. Cardiomegaly can be serious: depending on what part of the heart is enlarged, the patient can suffer from heart failure. Recent studies suggest that cardiomegaly is associated with a higher risk of sudden cardiac death. Heart failures increase with age, more common in males, and African Americans. According to research conducted in June 2019, half of people diagnosed with heart failure die within 5 years of being diagnosed. Cardiomyopathy is also associated with cardiomegaly.
  The causes of cardiomegaly vary from patient to patient, depending on each case. Many times this condition results from high blood pressure or coronary artery disease. An enlarged heart may not pump blood effectively, resulting in congestive heart failure. Cardiomegaly may improve over time, but many people with an enlarged heart need lifelong treatment with medications.
context_section_description: There are many techniques and tests used to diagnose an enlarged heart. The results of these tests can often be used to see how efficiently the heart is pumping, determine which chambers of the heart are enlarged, look for evidence of previous heart attacks and determine if a person has congenital heart disease.
  Risk factors for cardiomegaly include a family history of heart disease, diabetes, obesity, hypertension, history of alcohol or drug abuse, the lifestyle that consists of little or no exercise.
  Chest X-Ray: X-ray images help see the condition of the lungs and heart. If the heart is enlarged on an X-ray, other tests will usually be needed to find the cause. A useful measurement on X-ray is the cardio-thoracic ratio, which is the transverse diameter of the heart, compared with that of the thoracic cage." These diameters are taken from PA chest x-rays using the widest point of the chest and measuring as far as the lung pleura, not the lateral skin margins. If the cardiac thoracic ratio is greater than 50%, pathology is suspected, assuming the x-ray has been taken correctly. The measurement was first proposed in 1919 to screen military recruits. A newer approach to using these x-rays for evaluating heart health takes the ratio of heart area to chest area and has been called the two-dimensional cardiothoracic ratio.
  Electrocardiogram: This test records the electrical activity of the heart through electrodes attached to the person's skin. Impulses are recorded as waves and displayed on a monitor or printed on paper. This test helps diagnose heart rhythm problems and assess the damage to a person's heart from a heart attack.
  Echocardiogram: This test for diagnosing and monitoring an enlarged heart uses sound waves to produce a video image of the heart. With this test, the four chambers of the heart can be evaluated.
  Stress test: A stress test, also called an exercise stress test, provides information about how well the heart works during physical activity. It usually involves walking on a treadmill or riding a stationary bike while the heart rhythm, blood pressure, and breathing are monitored.
  Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI). In a cardiac CT scan, one lies on a table inside a machine called a gantry. An X-ray tube inside the machine rotates around the body and collects images of the heart and chest. In a cardiac MRI, one lies on a table inside a long tube-like machine that uses a magnetic field and radio waves to produce signals that create images of the heart.
  Blood tests: Blood tests may be ordered to check the levels of substances in the blood that may show a heart problem. Blood tests can also help rule out other conditions that may cause one's symptoms.
  Cardiac catheterization and biopsy: In this procedure, a thin tube (catheter) is inserted in the groin and threaded through the blood vessels to the heart, where a small sample (biopsy) of the heart, if indicated, can be extracted for laboratory analysis.
  For deceased people, cardiomegaly at autopsy has been suggested when the heart weighs more than >399 grams in women and >449 grams in men.
caption: Histopathology of (a) normal myocardium and (b) myocardial hypertrophy. Scale bar indicates 50 μm.
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