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Patients with cardiomyopathy, a stiffening and thickening of the heart muscle that weakens it, may develop an enlarged heart as it labors to pump an adequate supply of blood to the body. Coronary artery disease, in which plaque in the arteries interferes with the flow of blood, can cause the heart to enlarge.
Quick Answer. Possible causes of an enlarged heart include conditions that cause the heart to pump harder than normal, such as disease of the heart valve or muscle, and high blood pressure, according to Mayo Clinic. In some cases, the cause of an enlarged heart is unknown. Continue Reading.