Cardiomegaly overview: Difference between revisions
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===History and Symptoms=== | ===History and Symptoms=== | ||
The history and symptoms can suggest the underlying cause of cardiomegaly. The patient may have a history of [[rheumatic heart disease]] or [[congenital heart disease]], or a history of [[alcohol abuse]] which may suggest [[dilated cardiomyopathy]]. Symptoms such as chest pain, or other cardiac or respiratory symptoms may help in illiciting the underlying cause. | The history and symptoms can suggest the underlying cause of cardiomegaly. The patient may have a history of [[rheumatic heart disease]] or [[congenital heart disease]], or a history of [[alcohol abuse]] which may suggest [[dilated cardiomyopathy]]. Symptoms such as chest pain, or other cardiac or respiratory symptoms may help in illiciting the underlying cause. | ||
==Physical Examination== | |||
A comprehensive [[physical examination]] with a thorough cardiac exam will reveal cardiomegaly, and may indicated the nature of the underlying cause. The body habitus of the individual needs to be taken into account when evaluating findings on cardiac examination. | |||
===Echocardiogram=== | ===Echocardiogram=== | ||
Echocardiogram recommended for those patients presenting suspected [[valvular disease]], aberrant chamber size, ventricular function, and wall motion abnormalities. | Echocardiogram recommended for those patients presenting suspected [[valvular disease]], aberrant chamber size, ventricular function, and wall motion abnormalities. | ||
Revision as of 17:51, 3 January 2013
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Cardiomegaly Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Cardiomegaly overview On the Web |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor in Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Cardiomegaly is defined as an enlargement of the heart above its normal size. Cardiomegaly is generally first detected on chest X ray, and less often it is detected on routine physical examination. Cardiomegaly may be the first sign of an occult systemic or cardiovascular disease.
Pathophysiology
Cardiomegaly involves two main processes in the heart muscle. Hypertrophy causes the heart to enlarge due to thickening to the cardiac muscle, and dilation causes enlargement due to stretching of the heart muscle. Dilation occurs as a result of volume overload in the heart.
Causes
There are many causes for the condition of cardiomegaly, including medications, genetic conditions, endocrine conditions, infectious processes, toxins and iatrogenic causes.
Differentiating Cardiomegaly from other Diseases
There is a large differential for cardiomegaly, as it is a finding that is seen in many conditions. The differential can be narrowed based on the chamber of the heart affected, and whether the cardiomegaly is caused by dilation or by hypertrophy. Other physical findings, imaging studies, and laboratory findings need to be taken into consideration when determining the underlying diagnosis caused the manifestation of an enlarged heart.
Diagnosis
History and Symptoms
The history and symptoms can suggest the underlying cause of cardiomegaly. The patient may have a history of rheumatic heart disease or congenital heart disease, or a history of alcohol abuse which may suggest dilated cardiomyopathy. Symptoms such as chest pain, or other cardiac or respiratory symptoms may help in illiciting the underlying cause.
Physical Examination
A comprehensive physical examination with a thorough cardiac exam will reveal cardiomegaly, and may indicated the nature of the underlying cause. The body habitus of the individual needs to be taken into account when evaluating findings on cardiac examination.
Echocardiogram
Echocardiogram recommended for those patients presenting suspected valvular disease, aberrant chamber size, ventricular function, and wall motion abnormalities.
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.
Treatment
Surgery
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 may be considered in a few cases.