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Tests and diagnosis
By Mayo Clinic staffIf you have symptoms of a heart problem, your doctor will perform tests to determine if your heart is enlarged and to find out the underlying cause of your condition. In addition to a physical exam, these tests may include:
- Chest X-ray. X-ray images help your doctor see the condition of your lungs and heart. If your heart is enlarged it might first be detected by a chest X-ray, but other tests will usually be needed to find out the specific cause. Your doctor can also use an X-ray to diagnose conditions other than enlarged heart that may explain your signs and symptoms.
- Electrocardiogram. This test records the electrical activity of your heart through electrodes attached to your skin. Impulses are recorded as waves and displayed on a monitor or printed on paper. This test helps your doctor diagnose heart rhythm problems and damage to your heart from a heart attack as well as give clues to other types of heart disease.
- Echocardiogram. An important test for diagnosing and monitoring an enlarged heart is the echocardiogram. An echocardiogram uses sound waves to produce a video image of your heart. In this test all of the chambers of the heart can be evaluated to determine if you do have an enlarged heart and to try and determine the cause. This test determines how efficiently your heart is pumping, assesses your heart valves, can look for evidence of previous heart attacks and can determine if you have congenital heart disease.
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Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI). Although more commonly used to check for heart failure, more doctors are using these tests to diagnose heart problems. In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine called a gantry. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest.
In a cardiac MRI, you lie on a table inside a long tube-like machine that produces a magnetic field. The magnetic field aligns atomic particles in some of your cells. When radio waves are broadcast toward these aligned particles, they produce signals that vary according to the type of tissue they are. Images of your heart are created from these signals, which your doctor will look at to determine the cause of your enlarged heart.
- Blood tests. Your doctor may order blood tests to check the levels of certain substances in your blood that may signal that you have an enlarged heart. Blood tests can also help your doctor rule out other conditions that may cause your symptoms.
- Cardiac catheterization and biopsy. In this procedure, a thin tube (catheter) is inserted in your groin and threaded through your blood vessels to your heart, where a small sample (biopsy) of your heart can be extracted for analysis in the laboratory. Pressure within the chambers of your heart can be measured to see how forcefully blood pumps through your heart. Pictures of the arteries of the heart can be taken during the procedure (coronary angiogram) to ensure that you do not have any blockage.
- Enlarged heart. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4517. Accessed Dec. 14, 2008.
- Samariel AM, et al. Molecular and cellular biology of the normal, hypertrophied, and failing heart. In: Fuster V, et al. Hurst's The Heart, 12th ed. New York, N.Y.: Mc-Graw Hill Professional; 2008. http://www.accessmedicine.com/content.aspx?aID=3049170&searchStr=cardiomegaly. Accessed Dec. 17, 2008.
- Hill JA, et al. Cardiac plasticity. New England Journal of Medicine. 2008;358:1370.
- Cardiomyopathy. National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/cm/cm_all.html. Accessed Jan. 28, 2009.
- Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 17, 2009.
