Introduction

Heart enlargement or Cardiomegaly, described in simple words, means an increase in the size of the heart. It is not a disease, but rather a condition, due to other health problems in your body. Heart enlargement can be due to various reasons such as high blood pressure, pregnancy, heart valve disease, etc. These conditions make your heart pump blood more than its capacity, which causes it to stretch and enlarge. In the short term, it is indeed helpful and fulfils the body's requirement, but as time progresses, it results in a huge problem needing immediate medical attention.

It can be managed depending on what is causing heart enlargement in the first place, here we’ll be focusing on weight management.

Obesity¹ is a major risk factor for the development of cardiovascular disease. Excessive intake of high-fat and cholesterol diet causes weight gain and puts extra strain on the heart to pump more blood than the normal amount ( normal Ejection fraction 55-70% ² ) to meet the body's requirement for oxygen and nutrients. 

Therefore, it is important to do weight management to reduce the risk of heart conditions, as this can potentially reverse the heart condition and allow you to live a full and healthy life.

Types of cardiomegaly 

Dilated

It is one of the heart conditions that causes the ventricles of the heart to be thin and stretched. Thus, it weakens the heart when pumping blood throughout the body, because this process forces the heart to work even more. The most common form is cardiovascular disease, dilated cardiomegaly.

³ Dilated Cardiomyopathy

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Hypertrophic cardiomegaly

Hypertrophic or hypertrophy means an increase in the size of cells. In this case, it means an increase in the size of the muscles in the heart. In hypertrophic cardiomegaly, the heart muscles get thicker and stiffer than normal. This causes blockage in the ventricles of the heart, specifically the left ventricle. The heart fails to provide the quantity of blood required by the rest of the body, hence causing multiple other diseases. Any person suffering from this condition may have symptoms like shortness of breath, fatigue, swelling of the legs, chest pain, or even fainting.

(4)Illustration of asymmetric septal hypertrophy in HCM

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Causes of heart enlargement

• Hypertension
• Coronary Artery Disease
• Heart Valve disease
• Kidney Disease
• Thyroid Disorder
• Pregnancy
• Anemia
• Heart Attack

Risk factors

• Family history of Cardiomegaly
• Consumption of a diet containing fats and cholesterol
• Alcohol intake
• Sedentary lifestyle
• Diabetic 

Effects of excess weight on heart health

Increased heart strain

The heart has to pump blood to the entire body, but when the weight of your body is too much, it has to work harder to ensure proper circulation of blood and nutrients. When the heart pumps hard, the cardiac muscles enlarge, resulting in a condition called Left ventricular hypertrophy. It's similar to when you go to the gym and work out, your muscles in the arms or legs increase in size. The more you make your muscles work, the more their size will increase. 

Higher blood pressure

Obesity can cause high blood pressure because of excess deposits of fat in adipose tissues in the muscles. The body requires more blood and nutrients, which urges the heart to pump faster and increases the blood pressure. Again, the heart is working more than its defined capacity; it leads to heart enlargement along with the risk of hypertension.

Risk of atherosclerosis

Weight gain also leads to another condition called Atherosclerosis, the narrowing of arteries due to the accumulation of fats inside them. The narrowed arteries also do not allow smooth blood flow and cause restriction; therefore, the heart has to pump faster to increase the pressure for the blood to circulate through the body. Consequently, cardiomegaly can also be experienced as a result of atherosclerosis.

Description: This is an example of how the buildup of lipids (fat) in the artery prevents blood from flowing.

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Benefits of weight management 

Weight management is essential if you are suffering from heart disease. This improves the overall health and reduces occurrence of any other heart-related diseases.

Reducing heart strain

An excessive body weight causes the heart to pump beyond its normal capacity for the proper supply of blood and nutrients around the body. This puts a lot of strain on the heart, which causes cardiac muscles to expand, resulting in a situation known as left ventricular hypertrophy.. It's just like how you go to the gym and work out; your muscle inside your arm or legs increases in size. The more you make your muscles work, the more their size will increase.

Lowering blood pressure

Weight management can improve blood pressure. If you lose weight, then the heart does not have to work too hard to circulate blood in the body. This reduces the risks of developing any further diseases such as diabetes, stroke. 

Normal blood pressure ensures better blood flow, improved heart functioning and better quality of life.

Improved cholesterol levels

You can improve your diet by improving cholesterol levels in the blood, as they cause blockage of the arteries. It is best to switch to HDL (high-density lipoprotein) cholesterol as it is healthier than LDL(low-density lipoprotein) because high-density cholesterol is easily removed from the body, so there is storage of fats in the body. This reduces the chances of blockage and the development of any other condition.

How to manage diet for weight management

 If you want to manage your weight, you should probably run away from junk food or a diet containing high salt and start eating healthier food

Sure, it's frustrating, but don’t worry, you get used to it after a while. Some of the foods you should incorporate in your meal plan include

• Foods containing less salt
• Fruits
• Green Vegetables
• Eggs
• Yogurt
• Fish
• Legumes
• Beans and chickpeas

Be careful, do not put extra salt or seasoning while cooking, as this will defeat the entire purpose of the diet.

Prevention and reduction of comorbidities

Decreasing risk of diabetes ⁶

Not only does it prevent diseases related to the heart, but weight management also decreases the risk of diabetes. If you have a fat belly, then there is a chance that insulin won't be able to show its action as the cells in the body become resistant to the insulin, i.e insulin resistance. This leads to high sugar levels in the blood, causing diabetes.

Reducing the risk of sleep apnea

Excess weight can also cause Sleep Apnea or Obstructive Sleep Apnea, a condition which causes abnormal breathing. It is a very serious condition, and obese people are at high risk of developing it.

The excess weight in the chest area causes the airway pathway to constrict, which causes the narrowing of the pathway and makes it difficult to breathe while sleeping ⁶. You may find yourself snoring or having patterns of repeated shallow breaths with pauses.

Preventing further heart complications

Weight management improves general health conditions such as heart attack, Arrhythmias, and Angina. They are all related to improving the conditions of the arteries in the heart and the body. A healthy weight increases life expectancy, allowing a person to improve their quality of life. 

Psychological and quality of life benefits

Obesity does not only harm your body, but it also affects the individual mentally. Constant eating can also bring behavioural and psychological changes ⁷ including depression, high stress. Eat the right type of food, and you will see a significant difference in yourself as you will become more energetic and full of life. It also helps you find the lost confidence, which in turn will free you from self-criticism and move forward in character-building.

FAQs

Can losing weight reverse heart problems?

Yes, it can be reversed, however, full recovery is only possible if you started weight management earlier before the progression of the disease to the more severe level of the condition.

What is the common cause of Cardiomegaly?

The most common causes of an enlarged heart are unhealthy diet, high blood pressure and sedentary lifestyle. These are the main causes of heart enlargement and other cardiovascular-related diseases.

Which fruits are best for the heart?

Fruits such as apples, bananas, guava and papaya are the best fruits for a healthy heart.

Summary

Heart enlargement is a condition where the size of the heart increases more than the normal size. It is due to various reasons such as unhealthy diet, hypertension, diabetes and other disease conditions. Obesity is one of the most common causes of heart enlargement. The excess weight puts an extra load on the heart to pump blood for circulation to the entire body. This causes heart enlargement, which is classified as Dilated and Hypertrophic cardiomegaly. 

Weight management is important to reduce heart strain, lower blood pressure and reduce the risk of blockage of arteries. Weight management can also decrease the risk of developing other health conditions, such as diabetes and depression. You can manage your diet by visiting a dietitian and sharing your concerns regarding health, and the dietitian will make a diet plan according to your needs. You must stick to the diet plans for positive results and live a healthier and happier life.