Cardiomegaly

<Presentations>

<Index>

 

 

Definition

-  Enlargement of the heart as defined clinically or by CXR  (see below)

 

Classifications

-  Due to Dilation

-  Due to Ventricular hypertrophy

-  Causes: dilated, hypertrophic or mixed

-  Chronic HTN

-  Heart valve disorders (murmurs, IE)

-  IHD, CAD

-  Cardiomyopathy

-  Dilated: Myocarditis, cocaine abuse

-  Hypo/hyperthyroidsm

-  Severe anaemia

-  Congenital heart disease

-  Arythmias

-  Pulmonary hypertension

-  Amyloidosis

-  Previous AMI

 

Features

-  Typically due to cardiac failure: low CO

-  Sign of cardiac pathology, not a disease

-  May be picked up on CXR or by cinical examination

-  Clinically: PMI moved laterally

 

Assocated S/S

-  As related to cause

-  Commonly

-  Dyspnoea

-  Dizziness

-  Arythmias

-  Peripheral oedema

-  Cough

 

DDx

-  Pericardial effusion on CXR

 

Ix

- ECG: arythmia, enlarged chambers

-  Atrial enlargement

-  Tall P = left

-  Wide P = right

-  Ventricular enlargement

-  Left axis deviation = left

-  Right axis deviation = right

- Echo: valve disease, enlargement

- CXR: cardiomegaly = heart silouette > 50% transthoracic diameter

-  Increased cardiothoracic ratio > 0.50

 

 

Mx

-  As per underlying condition