Enlarged Heart (Cardiomegaly): Signs and Symptoms

An enlarged heart (also known as cardiomegaly) isn’t a condition on its own but is often an underlying sign of heart problems. Several conditions like coronary artery disease, high blood pressure, and kidney disease can cause an enlarged heart.

Some people with an enlarged heart don’t experience symptoms at all, but others may experience symptoms like trouble breathing, a racing heartbeat, and fluid build-up—all of which tend to worsen with physical exertion.

An enlarged heart can sometimes force your heart to work harder. When this happens, a common symptom you might experience is tachycardia (rapid heart rate). While it’s normal to notice an increased heart rate while exercising, tachycardia can cause a fast heartbeat while resting or performing chores at home.

Other symptoms may not be outwardly noticeable to you, but your healthcare provider can find signs of an enlarged heart during a routine physical exam. These signs may include:

• Low pulse pressure: Pulse pressure is the difference in numbers between systolic and diastolic blood pressure (top and bottom numbers). A lower pulse pressure happens because the heart doesn’t pump as much blood with each beat.
• Abnormal murmurs (heart sounds): When a healthcare provider listens to an enlarged heart, they might hear something called an S3 or S4 gallop. An S3 gallop is an extra sound when the heart relaxes and fills with blood. This can occur because too much blood is in the heart, and the heart muscle is weak. An S4 gallop is an extra sound when the heart has trouble properly relaxing.

An enlarged heart can cause difficulty breathing. That’s because your heart isn’t pumping blood effectively, which can often cause in fluid build-up in the lungs. This can also affect your heart’s ability to pump enough blood to other organs. As a result, you may experience the following symptoms:

• Shortness of breath
• Trouble breathing while lying down
• Extreme fatigue
• Poor tolerance to exercise
• Swelling and discomfort in the legs, ankles, feet, abdomen, and neck

Fluid build-up caused by an enlarged heart can also affect the digestive system. This buildup of fluid can put a strain on the stomach and intestines. As a result, you may experience symptoms such as:

• Loss of appetite
• Unintentional weight loss
• Nausea
• Early satiety (feeling full quickly)

Your medical history can offer important clues about your heart health. You may be at a higher risk of experiencing symptoms of an enlarged heart if you have a history of:

• Hypertension (high blood pressure)
• Diabetes
• Pregnancy
• Postpartum cardiomyopathy (heart weakness after giving birth)

An enlarged heart is often a symptom of an underlying heart condition. It’s worth noting that not everyone with an enlarged heart experiences symptoms. However, if you develop symptoms, you may notice a rapid heart rate, low pulse pressure, difficulty breathing, swelling, and fatigue.

Certain conditions like diabetes, high blood pressure, and pregnancy can increase your risk of developing symptoms. Reach out to a healthcare provider if you have symptoms.