Treatment

Treatments for an enlarged heart focus on correcting the cause.

Medications

If cardiomyopathy or another type of heart condition is to blame for your enlarged heart, your doctor may recommend medications. These may include:

• Diuretics to lower the amount of sodium and water in your body, which can help lower the pressure in your arteries and heart
• Angiotensin-converting enzyme (ACE) inhibitors to lower your blood pressure and improve your heart's pumping capability
• Angiotensin II receptor blockers (ARBs) to provide the benefits of ACE inhibitors for those who can't take ACE inhibitors
• Beta blockers to lower blood pressure and improve heart function
• Anticoagulants to reduce the risk of blood clots that could cause a heart attack or stroke
• Anti-arrhythmics to keep your heart beating with a normal rhythm

Surgery or other procedures

If medications aren't enough to treat your enlarged heart, medical procedures or surgery may be necessary.

• Medical devices to regulate your heartbeat. For a certain type of enlarged heart (dilated cardiomyopathy), a pacemaker that coordinates the contractions between the left and right ventricles may be necessary. In people who may be at risk of serious arrhythmias, drug therapy or an implantable cardioverter-defibrillator (ICD) may be an option.

  ICDs are small devices — about the size of a pager — implanted in your chest to continuously monitor your heart rhythm and deliver electrical shocks when needed to control abnormal, rapid heartbeats. The devices can also work as pacemakers.

  If the main cause of your enlarged heart is atrial fibrillation, then you may need procedures to return your heart to regular rhythm or to keep your heart from beating too quickly.

• Heart valve surgery. If your enlarged heart is caused by a problem with one of your heart valves or if it has caused heart valve problems, you may have surgery to repair or replace the affected valve.
• Coronary bypass surgery. If your enlarged heart is related to coronary artery disease, your doctor may recommend coronary artery bypass surgery.
• Left ventricular assist device (LVAD). If you have heart failure, you may need this implantable mechanical pump to help your weakened heart pump. You may have an LVAD implanted while you wait for a heart transplant or, if you're not a candidate for heart transplant, as a long-term treatment for heart failure.
• Heart transplant. If medications can't control your symptoms, a heart transplant may be a final option. Because of the shortage of donor hearts, even people who are critically ill may have a long wait before having a heart transplant.