How to diagnose cardiomegaly
Cardiomegaly may not cause symptoms, especially when it's mild or in the beginning stages, and you may not get a diagnosis of cardiomegaly on its own. It's more likely that your doctor will check for an enlarged heart if you come in with symptoms of another heart disease, such as heart palpitations or swelling due to an inefficient pumping from your heart.
Sometimes, a doctor may detect a heart murmur during a routine check and decide to look for other heart complications. It's also possible to see an enlarged heart on imaging tests taken for another reason. For instance, an enlarged heart may show up on a chest X-ray taken after a traumatic accident. For patients with high blood pressure or heart muscle defects, evidence of an enlarged heart can be seen on an EKG.
If your doctor suspects you have a heart condition associated with cardiomegaly—or if you have direct symptoms of an enlarged heart—they will order tests to evaluate your heart. These tests may include imaging that helps the care team understand what condition you're dealing with, what stage it's in, and how to treat it.
How to detect an enlarged heart
The most common way to diagnose cardiomegaly is with an echocardiogram, a simple ultrasound test for heart function. It's a painless imaging procedure that uses the same technology as the ultrasound used to look at developing babies. Medical staff will touch an ultrasound wand to your chest, allowing them to see whether the heart has grown abnormally large. Echocardiograms are also used to diagnose many other heart conditions, so the echo can help them understand what may be causing your enlarged heart.
Your doctor will look for the underlying heart condition causing your cardiomegaly, so they may do other tests, including:
- X-ray: A chest X-ray can show the heart and lungs.
- CT scan: This technology uses multiple X-ray images to create a three-dimensional image of the heart. They can even show blood flow through the heart, which can help diagnose conditions like mitral valve stenosis.
- MRI: Strong magnets can create a highly detailed image of the heart.
- Electrocardiogram (EKG/ECG): This test assesses the heart's activity using electrodes stuck to the skin.
- Genetic testing: Some heart conditions that cause cardiomegaly are genetic. Your doctor may want to check for these genetic diseases.
- Heart catheterization: In some cases a stress test may point to a need to look at the coronary arteries and to measure pressures within the heart that can rise due to conditions causing cardiomegaly.
Can an EKG detect an enlarged heart?
An EKG doesn't provide an image like many tests to diagnose cardiomegaly. Instead, it measures the heart's activity and shows it as electrical waves. If the waves are abnormally large in amplitude, it may indicate an enlarged heart, especially from an underlying heart muscle defect or effects of high blood pressure.
What cardiac condition shows cardiomegaly on a chest X-ray?
Cardiomegaly is a sign of many cardiac conditions. If you have an enlarged heart, it will appear abnormally large on a chest X-ray, regardless of what condition is causing the heart to be enlarged.
