What is cardiomegaly?


Cardiomegaly means that your heart is larger than normal. Often, it is a term used to describe the heart’s appearance on a chest X-ray.

There are several reasons your heart can appear to be large:

  • the main pumping chamber, the left ventricle, has become dilated over time, because the heart muscle is weak (dilated cardiomyopathy)
  • the heart muscle has become thick (hypertrophy) because it is pumping against a high blood pressure
  • there is fluid around the heart (pericardial effusion), making the heart shadow appear big (but it’s just the fluid around the heart, not the heart itself)


A patient with an enlarged heart. Image by Dr. James Heilman.


A normal chest X-ray, with a normal sized heart. Image by Yale Rosen.

If the heart appears to be large on the chest X-ray, then a transthoracic echocardiogram is often the next best test to look at the heart size, structure, and function to see if there is a problem.

Cardiomegaly is not a disease or condition; it’s just a description that tells you the heart appears large. It is important that a cause for cardiomegaly is found and investigated, so that a treatment can started if necessary.


Image by Blausen Medical.

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