Diagnosing an enlarged heart with the echocardiogram

Diagnosing an enlarged heart with the echocardiogram

How can an enlarged heart be diagnosed? A high-frequency sound wave test called an echocardiogram can provide initial insight.

Enlarged heart is a condition in which the heart is larger than normal. It can be classified into two major types: enlargement due to thicker muscle than usual, which is similar to bodybuilders who have larger muscles due to heavy physical work, and enlargement due to the heart being forced to work harder, such as in the case of high blood pressure or valve problems. In addition, there are many diseases that can cause the heart to enlarge, such as diabetes and thickening of the heart muscle without a known cause.

Enlarged heart does not necessarily cause any abnormal symptoms. If symptoms occur, they will be due to the underlying disease or heart failure, such as easy fatigue, shortness of breath, or chest tightness. Physical examination can determine if the heart is enlarged, but usually, it is more important to find the cause of the enlargement rather than just the size of the heart. Essential tests include an electrocardiogram and a chest X-ray (for the heart and lungs). If the heart muscle is significantly thicker than usual or has had previous problems with dead muscle tissue, it will be evident from the electrocardiogram. However, it is not always clear from an electrocardiogram alone what is causing the heart to be enlarged, and further tests may be necessary.

Diagnosis:

There is no single best method for diagnosis without any limitations, but currently, the most widely accepted method for examining the size of the heart is echocardiography, which is the examination of the heart using high-frequency sound waves. The principle is that the tool will send high-frequency sound waves through various parts of the organs, and these sound waves will reflect back. The ability to reflect back depends on the type of tissue it passes through, such as blood, bone, and muscle, which give different signals of reflection. The computer will record these reflections and create an image of the organ that the doctor is examining. Therefore, if the heart is examined, the doctor can see the heart chamber, measure its size, observe the function of the heart valve, see the heart muscle, and the ability to contract. Thus, this type of examination provides more details than other types of examinations. However, this examination does not show the blood vessels that nourish the heart, and the image may not be clear in obese or pulmonary disease patients (except for examination through the esophagus).

Who should get tested:

Individuals who should undergo this examination are those with symptoms of heart failure, coronary artery disease, high blood pressure, or those whose physical examination shows abnormal heart function. This examination is also recommended for those whose X-rays show that their heart is larger than normal to confirm if it is truly enlarged. However, the decision to perform this examination depends on the individual's condition and the physician's judgment. For patients at risk for coronary artery disease, such as those with diabetes, if their X-rays show that their heart is enlarged, they should also undergo a detailed examination. This is because the image may not be clear enough to determine the actual size of the heart, and further examination is needed to confirm the diagnosis.

Treatment:

Treating an enlarged heart involves treating the underlying cause, such as managing high blood pressure, performing heart valve surgery, or treating heart failure. Although treatment may not visibly reduce the size of the heart on X-rays in some cases, it can help prevent the heart from continuing to enlarge over time.