Definition of heart enlargement

Heart enlargement, medically known as cardiomegaly, occurs when the heart is bigger than its normal size. This means that the heart increases in size. 

Heart enlargement is a sign of a disease condition and not a disease condition itself. Certain types of heart disease can result in heart enlargement. Depending on the condition, heart enlargement may be temporary or permanent.

Heart enlargement is a sign of an underlying condition that puts a strain on the heart. This condition causes this organ to work harder. The heart may be thick or stretched. It may affect the whole organ or a part of it, leading to difficulty pumping blood.

What is the function of the heart?

The heart is a cone-shaped organ and the main part of the cardiovascular system. The cardiovascular system comprises organs that help to pump blood around the body. The heart helps to pump blood from the blood vessels and back to the rest of your body. While doing that, it supplies oxygen to the body and takes out carbon dioxide and other waste products. 

Also, it controls your heart rate and maintains blood pressure. 

Structure of the heart

The heart is located in-between the lungs. It is about the same size as its owner’s fist. It is divided into four chambers, namely:

• Right atrium 
• Right ventricle 
• Left atrium
• Left ventricle

Symptoms of heart enlargement 

Some people may experience few or no signs/symptoms at all. However, the following are symptoms of heart enlargement:

• Shortness of breath
• Chest pain
• Swelling in your feet or abdomen
• General discomfort
• Palpitations

Cause of heart enlargement?

Heart enlargement is caused by damage to the heart muscle or any condition that makes it work harder, this increases the heart’s workload, causing it to stretch or thicken, reducing its pumping efficiency. Just like clothing that loses shape and elasticity due to excessive wear, the heart can stretch and weaken. 

The following diseases can cause heart enlargement:

• Coronary artery disease
• Hypertension 
• Valvular heart disease
• Anaemia

Coronary artery disease- In this condition, blood flow to your Coronary arteries is limited. When plaque builds up in your coronary arteries over time, it becomes narrowed or blocked, resulting in coronary artery disease. 

Usually, coronary arteries supply oxygen-rich blood to your heart. When plaque builds up, it reduces or blocks blood flow to the heart, thereby reducing oxygen supply. Oxygen is the fuel of the heart, when it is reduced, the heart will have to work harder to compensate for the diminished oxygen, which causes the heart to enlarge.

Hypertension is also known as high blood pressure. If you have high blood pressure, your heart will have to pump harder to deliver blood to the rest of your body. This increased workload causes the heart muscle to enlarge.

Valvular heart disease, otherwise known as heart valve disease, occurs when there's damage to the heart valve. The heart has four valves that help to control the flow of blood through the heart. When any of the valves is damaged, blood flow will be affected and the heart has to work harder, resulting in heart enlargement. 

Anaemia is a condition characterised by a low red blood cell count. If your red blood cell count is low, there will be an insufficient amount of red blood cells to supply oxygen to the body tissues. This makes the heart pump more blood to compensate for the insufficiency. This situation causes a strain on the heart muscle, leading to heart enlargement.

Other underlying conditions include:

• Cardiac amyloidosis
• Hemochromatosis
• Thyroid disorders, etc.

Overview of diuretics 

Diuretics are also known as water pills. This class of drug helps the body to get rid of excess fluid and salt through urine. Diuretics are commonly used to treat conditions like hypertension and in conditions associated with fluid buildup, such as ascites, heart failure and liver cirrhosis. 

Types of diuretics 

Diuretics are mostly grouped based on their site of action in the kidney. The types include:

• Loop diuretics
• Thiazides 
• Potassium sparing diuretic
• Carbonic anhydrase
• Osmotic diuretics 

Loop diuretics: Loop diuretics are the most commonly used diuretics in managing excess body fluid. They’re said to be the most potent, they help remove excess salt (sodium and chloride) from the body by blocking the reabsorption of sodium and chloride by the kidney, which in turn promotes excretion of sodium and water by the kidney. They’re used in treating heart failure, oedema in nephrotic syndrome, hypertension, and congestive cardiac failure. Loop diuretics shouldn’t be considered as first-line drugs because they are powerful, so if there is a less powerful diuretic, that can be used. An example of a loop diuretic is furosemide. 

Thiazides: Thiazide diuretics are primarily used to treat high blood pressure. Thiazides decrease sodium reabsorption, which in turn increases fluid loss through urine, decreases blood volume, and decreases the workload on the heart. Examples include hydrochlorothiazide. 

Potassium-sparing diuretics: This type of diuretic is commonly used in treating potassium deficiency (hypokalaemia) in patients with hypertension. They increase loss of fluid and sodium while sparing potassium. They’re considered weak diuretics. They can be combined with either a loop diuretic or a thiazide. Examples include spironolactone. 

Carbonic anhydrase: This type of diuretic is used mostly in treating certain conditions affecting the eye. Carbonic anhydrase, also known as carbonic anhydrase inhibitors, helps prevent the reabsorption of sodium and bicarbonate, increasing urine production and reducing heart workloads.

Osmotic diuretics- Osmotic diuretics help increase the osmolarity of blood and renal filtrate, thereby increasing fluid loss. This type of diuretic is mostly administered intravenously and is used in reducing intracranial pressure, reducing intraocular pressure and promoting fluid loss. Example: mannitol. 

Benefits of diuretics in heart enlargement

Reduction of fluid overload - Diuretics help the kidneys to produce more urine, which leads to the removal of excess body fluid. This helps to alleviate symptoms like swelling and shortness of breath. The workload on the heart is reduced, and the quality of life is improved.

Lowering blood pressure - When sodium and excessive water are removed from the body, this lowers the amount of fluid flowing through your veins, hence red blood pressure and slowing the progression of heart enlargement.

Preventing complications - The effect of diuretics reduces the risk of heart failure and minimises complications.

Side effects of diuretics

The following are possible side effects:

• Dehydration 
• Headache 
• Weakness
• Dizziness
• Electrolyte imbalance 
• Hearing loss
• Kidney injury

Summary

Heart is the engine of the body with a vital function that once overworked can lead to major outcomes such as heart enlargement that can affect its capacity to pump blood adequately and to ensure blood circulation throughout the entire body. It is a sign of an underlying condition that puts a strain on the heart. 

Diseases such as coronary artery disease, hypertension, valvular heart diseases, anaemia, and others can engender heart enlargement.

Diuretics are also known as water pills. This class of drug helps the body to get rid of excess fluid and salt through urine. Diuretics are crucial in relieving symptoms of heart enlargement. However, an overuse of diuretics can lead to dehydration and electrolyte imbalance. 

Patients are encouraged to visit the healthcare providers as soon as they notice any changes in their health.