Why does the heart increase in a person and how to treat it?

Author Ольга Кияница

2017-10-31

Examination of some people indicates the presence of an enlarged heart. Whether it can be a variant of the norm and yet it is a matter of pathology can be reliably said after ascertaining the cause of such manifestation. If a violation of the development of the body affects its functioning, then necessarily appropriate treatment should be carried out.

The increase in the heart in the medical language sounds like cardiomegaly. This condition is often associated with hypertrophy of the left ventricle. In fact, these are two different pathologies. With cardiomegaly, there is an increase in the mass of the entire organ, as well as an increase in its cavities. With left ventricular hypertrophy, the remaining chambers do not change. Also, a large heart can be a variant of the norm if its owner, for example, is a professional sportsman

In normal condition, the adult's heart is determined by the length of the heart about 11 cm, width - 9.5 cm, wall thickness - 7 cm. In children in the first months after birth, the size of the heart is much less - respectively 3x4x2 cm. The weight of the organ also depends on the age - adult about 250 grams, and for a newborn - about 20 grams.

Various modern methods of research are used to determine the size of the heart. First of all, the patient is examined by a doctor, then an x-ray is made, ultrasound of the heart is also performed. If there is any doubt, then magnetic resonance imaging is used. Establishing an accurate diagnosis and finding out the cause of the disease allows for more effective treatment.

Video The big heart disease (cardiomegaly)

Causes of enlarged heart

The change in the size of the heart in the direction of increase can occur for various reasons.

  1. Compensatory increase, close to the physiological state. Most often noted in physically trained people, when due to an increase in body weight and oxygen consumption by tissues, the heart mass increases, which allows more intensive blood pumping. Such a sign indicates the endurance of a person and in the absence of other heart diseases does not pose any threat to the health.
  2. Hypertrophy of the left ventricle - develops due to cardiovascular diseases, which are associated with a violation of blood flow in a large range of blood circulation. This is mainly found in hypertrophic cardiomyopathy (hereditary disease), aortic insufficiency or aortic stenosis, atherosclerosis of valves (often found in the elderly).
  3. Cardiomegaly - the whole heart increases in mass and size, while the provoking factor is the pathology of the cardiovascular system, or heart tumors in the form of myxoma, rhabdomyoma.

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The enlargement of the heart can be determined in diseases of other organs and systems of the body. Often, the development of pathology contributes to diabetes, because there is a violation of fat and carbohydrate metabolism. Other predisposing factors are anemia, obesity, irrational diets and so on.

Symptoms of a large heart

The specificity of the clinical picture with an enlarged heart is absent. Much depends on the underlying pathology, which was complicated by cardiomegaly or hypertrophy of the left ventricle. If we are talking only about cardiovascular diseases, then more cardiac symptoms appear: heart pain, shortness of breath, heart rhythm disturbance, increase or decrease in blood pressure.

With a physiological form of augmentation of the heart, there are no symptoms. The person feels like usual, nothing disturbs him.

In emotionally labile people, in addition to cardiac symptoms, vegetative disorders can be noted. The skin becomes pale and sweats. Often there is dizziness, faintness develops. If fainting occurs, you should immediately consult a doctor, as the disease, most often, went into the stage of decompensation, when the body's resources are not enough to normalize the condition.

Enlarged heart in children and fetus

Unfortunately, during an intrauterine development, an enlarged heart can also be determined. Pathology can be triggered by a variety of adverse factors that affect the woman during pregnancy, and through it to the fetus.

The cardiovascular system begins to be laid already in the second week of pregnancy. Especially important processes are performed before the eighth week. But in the future the formation of a vital organ takes place, in particular, the process of laying four chambers of the heart continues until the third month of pregnancy.

The main factors, the effect of which leads to an increase in the heart of the fetus:

  • Radioactive and ionizing radiation.
  • The infectious diseases transferred during pregnancy, especially of a virus origin (a rubella, a toxoplasmosis, a herpes, some strains of a flu).
  • Drugs, alcohol or smoking.
  • Incorrect intake of certain drugs or use of unacceptable drugs (barbiturates, anticonvulsants, etc.).
  • Malnutrition, malnutrition or starvation, lack of vitamins.
  • Strong stress or exorbitant physical activity.

In some cases, an adverse role is played by adverse heredity, which is most often noted on the maternal line.

Moderate cardiomegaly in the fetus can be determined by the abnormality of Ebstein, as well as other cardiac malformations. In some cases there is a combination pathology incompatible with life. There is a birth of kids with Down's syndrome and heart pathology, including cardiomegaly. If the exact cause of the development of pathology is unknown, then they talk about idiopathic cardiomegaly.

Children who have heart problems after birth are poorly sucked, or shortness of breath occurs during suckling or crying. Also, when you shout, the color of the face, hands and feet changes, which become cyanotic.During wakefulness, the baby may have tachycardia, that is, a heart rate of 170 beats / min and above.

The fate of newborns with cardiomegaly is ambiguous. About 45% of children survive and doctors help them lead a healthy life. Up to 30% of children with pathology die and about the same number have severe cardiovascular disorders, but are compatible with life.

In pre-school and school age, an enlarged heart can also be determined.In such cases, most often the cause is heart disease, congenital or acquired. The following manifestations can lead to the idea of a disease:

  • frequent fatigue;
  • increased fatigue;
  • poor sleep;
  • low school performance;
  • emotional instability;
  • neurological disorders.

The definition of such signs should lead to an early visit to the cardiologist. Slowness in this matter may contribute to the development of other complications. In childhood, treatment and diagnosis of an enlarged heart are similar to similar activities conducted by an adult.

Diagnosis of enlarged heart

To diagnose cardiomegaly, left ventricular hypertrophy, or to attribute pathology to the variant of the norm, first of all, use echocardioscopy (ultrasound of the heart).
Normal indicators of the US heart of an adult:

  • Shock volume in the range of 60-80 ml.
  • The ejection fraction is determined in the region of 55-65%.
  • The final volume of systole is 45-75 ml.
  • The final volume of diastole is 110-145 ml.

Video Cardiomegaly, stretching of all cavities of heart, disturbance of rhythm of DCMP

 

The volumetric indices presented above increase noticeably with a large heart. In the course of echocardioscopy, the thickness of the walls of the heart cavities and hypertrophied parts of it is necessarily measured. Ultrasound also assesses the condition of the valve apparatus. If there are slight changes in the parameters, then, most likely, there is heart failure or dilated cardiomyopathy.

Additional research methods:

  • electrocardiography;
  • X-ray of the thoracic cavity organs;
  • Magnetic resonance imaging;
  • puncture biopsy of the heart tissue (performed to determine the tumor cells).

Newborns and up to one year most often only the ultrasound of the heart. Only in extreme cases can radiography of WGCs be performed. If there are any suspicions of pathology in athletes or people of hypersthenic type of physique, then for the purpose of prevention, ultrasound or radiography is performed.

Healing of a large heart

There are several tactics for treating sick children with cardiomegaly. If there are no heart defects, then captopril is prescribed, which by inhibiting the ACE protects the heart tissue from various negative effects. The drug is taken for a long time and after a period of time an ultrasound examination is carried out. With positive dynamics, there will be a decrease in such indicators as the final volume of systole and the final volume of diastole.

The presence of a congenital or acquired defect in a child is a direct indication for examination by a cardiac surgeon, which will give an opinion on the need for an operation.

Treatment of enlarged heart in adults is primarily associated with the elimination of the cause that caused the disease. Therefore for an example it is possible to result some tactics of treatment:

  • Heart defects depending on the complexity of the pathology are often treated operatively.
  • Chronic heart failure - with the help of diuretics (for example, veroshpirona or indapamide).
  • Hypertension - drugs that lower blood pressure (enalapril or perindopril).
  • Hormonal disorders - through endocrinological drugs, selected by a doctor.

In special cases, when drug treatment does not help, and the quality of life is sharply reduced, the patient is recommended a heart transplant. With modern technology, more and more foreign clinics conduct this operation with a high degree of success.

Prognosis for cardiomegaly

There are several characteristics that affect the prognostic value:

  • nature of the disease;
  • degree of progression of pathology;
  • the duration of the course of the underlying disease that caused the enlargement of the heart.

For example, an extremely rapid course of the disease is observed in chronic heart failure, complicated by dilated cardiac enlargement. In such cases, a lethal outcome can occur in two to three years. A more favorable prognosis is posed with successfully operated heart defects and absence of cardiac insufficiency. A more accurate prognostic conclusion is given by the attending physician, who also observes the development of the disease in dynamics and knows the features of the particular patient.


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