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Cardiac
enlargement can sometimes be diagnosed based on a physical examination by a
physician or other health care provider. A patient’s symptoms or family medical
history, high blood pressure, characteristic heart murmur, forceful heart beat,
swelling of the legs, or the sound of fluid in the lungs can be clues to the
diagnosis. A chest x-ray can show an enlarged heart size or fluid in the lungs
and an ECG will often show increased waveforms, indicating LVH or RVH. In fact,
it has been suggested that ECG be used to screen young athletes for hypertrophic
cardiomyopathy. Unfortunately, cost issues are likely to prevent this from being
done on a large-scale basis.
The best
way for a physician to evaluate cardiac enlargement is with an echocardiogram.
This test uses a form of ultrasound similar to that used to look at
gallbladders, kidneys, and pregnant women’s babies. Using a sophisticated
computer and monitor and a small plastic probe and some gel placed on the chest,
the echocardiogram can directly show the size and thickness of the heart muscle
in each chamber. It can also gauge heart function, an important piece on
information when deciding how to treat the enlargement. Some
people can have varying degrees of cardiac enlargement and have no symptoms.
Once dilation or hypertrophy begins to place undue demands on heart function,
however, symptoms do result. These can include:
- Shortness of breath
- Chest pressure or
pain
- Palpitations (a sense
that the heart is beating rapidly or forcefully or “skipping beats”)
- Swelling of the feet,
ankles, or legs
- Dizziness or
lightheadedness
- Loss of
consciousness
In
milder forms of cardiac enlargement, the symptoms may occur only with exercise
or exertion. In more severe forms, they can occur at any time, even while
resting. Other heart and lung problems and other diseases can cause these
symptoms as well, so they are not specific to cardiac
enlargement.
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