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Harvard Medical School
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General Medical Questions
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Q: My doctor told me I have an enlarged heart. I have high blood pressure, but otherwise feel fine. What can you tell me about the causes, symptoms and treatment options for an enlarged heart?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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November 05, 2009
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A:

This term most often describes the appearance of the heart on a chest x-ray. Radiologists who read chest x-rays routinely comment on the heart size. However, the size of the heart measured on a chest x-ray is often not a good indicator of whether the heart is abnormal.

You will need an echocardiogram. It uses sound waves to create detailed pictures of all the chambers of the heart and the heart valves. The pictures also show how well each part of the heart is functioning and whether blood flow is always moving in the right direction.

Your heart might not even be enlarged. And if it is slightly bigger than expected, and the echocardiogram is otherwise completely normal, you can be reassured that this is normal for you.

People with high blood pressure who don't keep it under control can develop a large left ventricle. The left ventricle is the main pumping chamber in the heart. It needs to push blood out to the rest of the body.

Make sure you ask about the size of your left ventricle and whether the thickness of its wall is normal. A thick left ventricle wall, called left ventricular hypertrophy, indicates that you need to get your blood pressure to even lower levels.

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