Cardiomegaly

Cardiomegaly Microchapters
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Overview
Historical Perspective
Pathophysiology
Causes
Differentiating Cardiomegaly from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
MRI
CT
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
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Future or Investigational Therapies
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Case #1
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor in Chief: Cafer Zorkun, M.D., Ph.D. [2]

Diagnosis

History and Symptoms | Physical examination | Lab tests | Electrocardiogram | Chest x ray | MRI | CT | Echocardiogpraphy or ultrasound | Other diagnostic studies | Pathological findings

Other Diagnostic Studies

• Exercise or pharmacologic stress testing may be indicated in those patients suspected of having coronary artery disease
• Patients suspected of having valvular disease or coronary artery disease may need a cardiac catheterization for full evaluation following echocardiography

Pathological Findings

Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

Right ventricular enlargement due to a patent ductus arteriosus in a patient with hyaline membrane disease

Pharmacotherapy

Acute Pharmacotherapies

• Administration of digoxin, diuretics, antiarrhythmics and/or preload and afterload reducers per clinical indication

Chronic Pharmacotherapies

A combination of diuretics and angiotensin converting enzyme (ACE) inhibition is currently the standard of care. Digoxin may reduce the frequency of rehospitalization, but does not improve mortality.

Surgery and Device Based Therapy

• In patients who are awaiting a transplant for end-stage symptomatic heart failure, implantable ventricular assist devices may serve as a temporary aid for compensation.

Transplantation

• In patients who are in end-stage symptomatic heart failure, a heart transplant my be necessary.

Future or Investigational Therapies

Mechanical strategies currently under investigation include:

1. Development of devices to reduce the size of the heart
2. Development of a device to exclude that portion of the apex where clots may form.

Pathological Findings

Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

Biventricular Hypertrophy

Biventricular Hypertrophy

Gross excellent example of concentric left ventricular hypertrophy

Left Ventricular Hypertrophy: Gross natural color anterior view intact heart showing disproportionate size of left ventricle by its inferior extent much below the right ventricle apex (quite good example)

Myocardial Infarct: Gross natural color apical section showing large left ventricle infarct and right ventricular hypertrophy

Right ventricular hypertrophy

References

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