Enlarged hearts must pump more often to supply enough blood to the body, which requires additional energy. Infants with enlarged hearts tire easily, making it difficult for them to take in enough calories by mouth to give them the additional energy they need just to survive. Such infants often require enteral feeding through a nasogastric tube, which supplies nutrition directly to the stomach through gravity. A tube placed directly into the stomach or small intestine through the abdominal wall can also supply nutrition.

In some instances the heart may be thought to be enlarged but really isn’t. This can occasionally may be the case in a child who is referred for an enlarged heart on x-ray. The x-ray creates an image of the heart and lungs almost like creating a shadow on a wall. Sometimes variation in the position of the child or the depth of inspiration when the chest ray is taken can affect the appearance of the heart. In this situation, an echocardiogram can accurately determine the exact size of the heart. In some cases a child referred for an enlarged heart on x-ray actually end up having a perfectly normal heart size when we look at it with an echocardiogram.

Heart surgery for infants with enlarged hearts can consist of repair of abnormal blood vessels or other problems or can require a complete heart transplantation. Devices that automatically supply a shock when the heart goes into a dangerous arrhythmia, called an ICD, internal cardioverter/defibrillator can be surgically implanted to help children with cardiomyopathy, Cincinnati Children’s Hospital explains.

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Likewise, sometimes an enlarged heart can be a normal variant. Athletic training causes an increase in heart size due to exercise. Just as athletic training builds other muscles in the body, it can also build the heart muscle. In this circumstance, a slightly enlarged heart may be a good thing! No one would consider a mildly enlarged heart from athletic training to be a problem!

A number of conditions can lead to heart enlargement, also called cardiac hypertrophy, in infants. Around 1 percent of infants have congenital cardiac defects, the most common congenital defect found in newborns, the American Heart Association reports. Congestive heart failure and cardiomyopathy are two conditions that result in heart enlargement in infants. The treatment for an enlarged heart depends on the cause of the enlargement.

The term enlarged heart simply means a heart which is bigger than normal. The most important question is what is the cause of the enlarged heart? Causes of an enlarged heart may range from normal variants up to life-threatening problems.

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What is an enlarged heart? Details Published: 23 October 2015

A number of medications treat enlarged heart in infants. Some, such as diuretics, decrease the workload of the heart by decreasing the amount of blood that has to be pumped through it. Medications such as digitalis help the heart beat slower but stronger, which increases its efficiency. Anti-arrhythmia medications and blood pressure medications that slow and strengthen the heartbeat may also be prescribed for cardiomyopathy or congestive heart failure.

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Infants with seriously enlarged hearts from heart failure may require ECMO, extra-corporeal membrane oxygenation, a type of heart-lung bypass machine. ECMO may be used as bridge to buy time in an infant waiting for a heart transplant. Another type of ventricular assist machine, called the Berlin heart and available for use in a few specialized hospitals, can be used for up to a year, Children’s Memorial Hospital of Chicago reports.

Questions about an enlarged heart come up fairly often. Not infrequently a child is referred because a chest x-ray demonstrates an “enlarged heart”. Likewise, I often hear from parents who tell me that they had a relative who was diagnosed with an enlarged heart. So, what is an enlarged heart?

Some cases of enlarged hearts in children are caused by valve problems. Valves that don’t open properly, or valves that leak can create an extra stress on the heart, resulting in enlargement. For example, many children with significant aortic regurgitation caused by a bicuspid aortic valve may develop enlargement of the left ventricle over time. This can be an indication for replacement of the valve.

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A final cause of an enlarged heart is any problem with the heart muscle in terms of its contractility or squeezing function. This is usually the cause of an enlarged heart in adults. It can also be seen in children but is less common. Example of an enlarged heart in this situation would include a cardiomyopathy, or heart muscle disease. In this setting, the heart muscle doesn’t squeeze well and enlarges as a compensatory mechanism.

Articles from Journal of Emergencies, Trauma, and Shock are provided here courtesy of Wolters Kluwer — Medknow Publications

In summary, there are many causes of an enlarged heart in children, some of them potentially normal. Certainly if there is any suggestion of an enlarged heart in your child, make sure to check it out!

Unfortunately, sometimes an enlarged heart is truly abnormal. The heart can enlarge from a number of different causes. In children, the most common reason is some form of congenital heart defect. For example, a hole in the heart (or some other abnormality) may allow blood to shunt or recirculate back to the lungs. Examples of shunts include a ventricular septal defect, atrial septal defect, and patent ductus arteriosus. In all of these examples, a communication exists which allows blood to recirculate to the lungs. This ends up sending more blood than normal to the lungs; subsequently more blood returns to back to the heart. The heart subsequently enlarges because of the extra volume delivered to it.

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