CARDIOMEGALY
SUBMIT TED BY,
SHEELA M JOHN
2 ND YEAR MSC NURSING
INTRODUCTION
• Cardiomegaly is a medical condition in which the heart is enlarged.
• It is more commonly referred to as an enlarged heart.
• Other common names for cardiomegaly is megacardia or
megalocardia, but they all refer to the same thing.
• The causes of cardiomegaly vary from patient to
patient,depending on each case.
DEFINITION
Cardiomegaly is a medical condition in which the
heart is enlarged. It is more commonly referred to
as an enlarged heart.
An enlarged heart may not pump blood effectively,
resulting in congestive heart failure.
ETIOLOGY
Idiopathic: an enlarged heart can be caused by conditions that caused by conditions
that cause heart to pump harder than usual or that damage heart muscle. Sometimes
the heart enlarges and becomes weak for unknown reasons.
Diseases of the heart muscle or heart valves, as the thickening and stiffening of
heart muscles progresses, the heart may enlarge to try to pump more blood to the
body.
High blood pressure
Arrhythmias: A congenital heart condition, damage from a heart attack or an
abnormal heartbeat can cause heart to enlarge.
Infectious endocarditis, connective tissue disorders, certain medications or
radiation treatments for cancer, the heart may enlarge.
Pulmonary hypertension.
Longstanding anemia (Low red blood cell count)
Thyroid diseases.
Pericardial effusion: Accumulation of fluid in the sac(pericardium) that
contains the heart may cause heart to appear enlarged on a chest xray.
Excessive iron in blood (hemochromatosis): It is a disorder in which the
body doesn’t properly metabolize iron, causing it to build up in various
organs, including heart.
Rare diseases such as Amyloidosis (It is a condition in which abnormal
proteins circulate in blood and may be deposited in heart, interfering with
heart’s function and causing it to enlarge.
Viral infection of the heart.
Pregnancy, with enlarged heart developing around the
time of delivery (peripartum cardiomyopathy)
Kidney diseases requiring dialysis
HIV infection
Alcohol or cocaine abuse
Diabetes
RISK FACTORS
High blood pressure : higher than 140/90 millimeters of
mercury
A family history of enlarged hearts or cardiomyopathy
Coronary artery disease
Congenital heart disease
Valvular heart disease
Heart attack
CLASSIFICATION
Ventricular hypertrophy (VH):
• It is thickening of the walls of
a ventricle (lower chamber) of
the heart. Although left ventricular
hypertrophy (LVH) is more common,
rightventricular hypertrophy (RVH), as
well as concurrent hypertrophy of both
ventricles can also occur.
Atrial enlargement
• It refers to a condition where
the left atrium or right
atrium of the heart is larger
than would be expected.
• It can also affect both atria.
Dilated cardiomyopathy
• It is the most common type of cardiomegaly. In this
condition, the walls of the left and/or right ventricles
of the heart become thin and stretched.
• The result is an enlarged heart.
• In the other types of cardiomegaly, the heart's large
muscular left ventricle becomes abnormally thick.
• Hypertrophy is usually what causes left ventricular
enlargement.
Hypertrophic cardiomyopathy
It is typically an inherited condition
SIGNS AND SYMPTOMS
Heart palpitations
Severe shortness of breath (especially
physically active)-irregulary unable to catch
one’s breath.
Chest pain
Fatigue
Swelling in legs
Increased abdominal girth
Weight gain
Edema
Fainting
DIAGNOSTIC EVALUATION
Chest xray
Electrocardiogram
Echocardiogram
Stress test
Cardiac computerized tomography or MRI
Blood test
Cardiac catheterization
Biopsy
MEDICAL MANAGEMENT
Diuretics: To lower the amount of sodium and
water in the body, which can help lowers the
pressure in the arteries and heart.
Angiotensin-converting enzyme inhibitors
(ACE) : To lower the BP and improves the
heart pumping ability.
Angiotensin receptor blockers (ARBs): To
provide the benefits of ACE inhibitors for
those who cannot take ACE inhibitors.
Beta blockers: To lower blood pressure
and improve heart function.
Digoxin: To help improve the pumping
function of the heart and lessen the need
for hospitalization for heart failure.
Anticoagulants: To reduce the risk of
blood clots that could cause a heart attack
or stroke.
Anti-arrythmics: To keep the heart
beating with a normal rhythm.
SURGICAL MANAGEMENT
Pacemaker: It coordinates the contractions between
the left and right ventricle.
In people who may be at risk of serious arrythmias,
drug therapy or an implantable cardioverter-
defibrillator may be an option.
Heart valve surgery: to remove the valve and
replace it with either an artificial valve from a pig,
cow or deceased human donor
Coronary bypass surgery
Left ventricular assist device
Heart transplant
COMPLICATIONS
Heart failure
Blood clots
Heart murmur
Cardiac arrest
Sudden death
LIFESTYLE MODIFICATIONS
Quit smoking.
Lose excess weight.
Limit salt in the diet.
Control diabetes.
Monitor blood pressure.
Get modest exercises, after discussing with
the doctor the most appropriate program of
physical activity.
Avoid or eliminate alcohol and caffeine.
Try to sleep eight hours nightly.
CONCLUSION
• Cardiomegaly (megacardia or megalocardia) is a
medical condition in which the heart is enlarged.
• As such, it is more commonly referred to simply as
"having an enlarged heart".
• It is not a disease, but rather a condition that can
result from a host of other diseases such as obesity or
coronary artery disease.
BIBLIOGRAPHY
Brunner and Sudharth’s .Textbook of Medical Surgical
nursing: Lippincott Publishers: Page no.1208-1212.
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