Enlarged Heart (Cardiomegaly) in Grand Rapids, Michigan

The heart is a muscular pump about the size of a clenched fist. An enlarged heart is not a disease by itself, but a sign that the heart is working harder than normal because of an underlying condition. Older adults in Grand Rapids and across West Michigan are at higher risk of developing an enlarged heart (cardiomegaly), especially if they have high blood pressure, heart disease, or other chronic conditions.

Cold Michigan winters, less outdoor activity, and higher rates of high blood pressure and obesity in the Midwest can all contribute to heart strain and enlargement over time.

What Is an Enlarged Heart (Cardiomegaly)?

Another name for an enlarged heart is cardiomegaly

“Cardiomegaly” simply means “enlarged heart.” It can affect one or more chambers of the heart and may be:

  • Physiological (functional) – when other conditions force the heart to work harder, such as:
    • High blood pressure (hypertension)
    • Thyroid disease
    • Heart valve problems
    • Long-standing obesity

In many people in the Grand Rapids area, long-term, untreated high blood pressure is one of the most common reasons the heart becomes enlarged.

Can an Enlarged Heart Have No Symptoms?

In some cases, an enlarged heart is asymptomatic

Some people with an enlarged heart have no symptoms at all, and the condition is only found on a chest x‑ray, echocardiogram, or other test done for another reason.

When symptoms do occur, it is often because the heart can no longer pump blood effectively. This can lead to congestive heart failure, a condition where fluid builds up in the lungs, legs, and other parts of the body.

Symptoms of an Enlarged Heart

Symptoms may include fluid retention and breathing problems

Symptoms can develop slowly over time or appear more suddenly, especially after a viral illness or heart attack. Common symptoms include:

  • Shortness of breath, especially:
    • With activity
    • When lying flat
  • Swelling (fluid retention) in:
    • Ankles
    • Legs
    • Feet
    • Abdomen
  • Fatigue or weakness
  • Dizziness or lightheadedness
  • Irregular heartbeat (arrhythmia)
  • Heart palpitations (feeling like your heart is racing or skipping beats)
  • Chest discomfort or pain (especially with exertion)

If you experience sudden shortness of breath, chest pain, or fainting in Grand Rapids, call 911 or go to the nearest emergency department at Corewell Health (formerly Spectrum Health) Butterworth Hospital, Trinity Health Grand Rapids, or another local emergency facility.

Common Causes of an Enlarged Heart in Grand Rapids

An enlarged heart can have many causes. Some of the key underlying conditions include:

Coronary Artery Disease (CAD)

  • Fatty deposits (plaques) build up inside the coronary arteries, which supply blood to the heart muscle.
  • This buildup (atherosclerosis) narrows the arteries and reduces oxygen supply to the heart.
  • When the heart isn’t getting enough oxygen, it has to pump harder, which can cause the heart muscle to thicken or the chambers to enlarge.
  • CAD is common in Michigan and is strongly linked to:
    • High cholesterol
    • Smoking
    • Diabetes
    • Lack of exercise
    • Unhealthy diet

High Blood Pressure (Hypertension)

  • Long-term high blood pressure forces the heart to pump against increased resistance.
  • Over time, this extra workload can cause the heart muscle to thicken and the chambers to enlarge.
  • Causes of high blood pressure include:
    • Obesity
    • Sedentary lifestyle (especially during long West Michigan winters)
    • High-salt diet
    • Family history of hypertension
  • Hypertension is very common in Kent County and is a major risk factor for cardiomegaly.

Dilated Cardiomyopathy

Enlarged or “dilated” heart is one of the most common types of cardiomyopathy

  • Dilated cardiomyopathy is a disease of the heart muscle in which one or more chambers become enlarged and pump weakly.
  • The exact cause is often unknown (idiopathic), but it can be related to:
    • Viral infections
    • Alcohol abuse
    • Certain medications or chemotherapy
    • Genetic (inherited) factors

Most common symptoms of cardiomyopathy:

  • Shortness of breath
  • Swelling of the ankles and legs

Rarer symptoms can include:

  • Dizziness
  • Chest pain
  • Fainting

Myocarditis (Heart Muscle Inflammation)

  • Myocarditis is an infection or inflammation of the heart muscle, usually caused by a virus.
  • A person may have a viral illness first (fever, sore throat, body aches) and later develop:
    • Shortness of breath
    • Fatigue
    • Swelling
    • Signs of heart failure
  • Myocarditis can lead to a weakened and enlarged heart.

Heart Valve Disease

  • Faulty heart valves (such as a leaking mitral valve) allow blood to flow backward.
  • This forces the affected heart chamber to contract more strongly to move the same amount of blood forward.
  • Over time, this extra workload can cause the chamber to enlarge.
  • Valve disease may be caused by:
    • Congenital (birth) defects
    • Rheumatic fever
    • Age-related wear and tear

Previous Heart Attack

  • A heart attack damages part of the heart muscle.
  • The remaining healthy muscle may enlarge and stretch to compensate and keep up with the body’s demands.
  • This can lead to an enlarged, weakened heart and eventually heart failure if not treated.

Thyroid Disease

  • The thyroid gland regulates metabolism and affects heart rate and blood pressure.
  • Both overactive thyroid (hyperthyroidism) and underactive thyroid (hypothyroidism) can strain the heart.
  • If untreated, thyroid disease can lead to:
    • High blood pressure
    • High cholesterol
    • Irregular heartbeat
    • Enlargement of the heart

Obesity

  • Carrying too much body fat raises the risk of:
    • High blood pressure
    • High cholesterol
    • Type 2 diabetes
  • These conditions all increase the workload on the heart and can contribute to cardiomegaly.
  • Obesity is a growing concern in Michigan, making weight management an important part of heart disease prevention in Grand Rapids.

Lack of Exercise

  • A sedentary lifestyle is a known risk factor for:
    • Coronary heart disease
    • High blood pressure
    • Obesity
  • Many Grand Rapids residents are less active during cold and snowy months, which can worsen these risk factors if not balanced with indoor exercise.

Older Age

  • As we age, our arteries lose some of their elasticity.
  • This “stiffening” of blood vessels can lead to high blood pressure.
  • High blood pressure, in turn, is a major risk factor for an enlarged heart.
  • Older adults in Grand Rapids should have regular blood pressure and heart health checks with their primary care provider or cardiologist.

How Is an Enlarged Heart Diagnosed in Grand Rapids?

If your doctor in Grand Rapids suspects an enlarged heart, they may refer you to a cardiologist at Corewell Health, Trinity Health Grand Rapids, Metro Health – University of Michigan Health, or Mercy Health for further evaluation.

Common diagnostic tests include:

Medical History and Physical Exam

  • Review of symptoms (shortness of breath, swelling, chest pain, palpitations)
  • Discussion of risk factors (family history, smoking, high blood pressure, diabetes)
  • Listening to the heart and lungs
  • Checking for leg swelling and other signs of heart failure

Chest X‑Ray

  • Shows the overall size and shape of the heart and lungs.
  • Can help detect an enlarged heart and fluid in the lungs.

Echocardiogram (Heart Ultrasound)

  • Uses sound waves to create a moving picture of the beating heart.
  • Allows the doctor to see:
    • Heart chamber size
    • Pumping strength (ejection fraction)
    • Heart valve function
    • Wall thickness and movement

Doppler Study

  • A specialized part of the echocardiogram.
  • Shows blood flow through the heart valves.
  • Helps determine whether valves are leaking or narrowed.

Electrocardiogram (ECG or EKG)

  • Measures the electrical activity of the heart.
  • Can detect:
    • Irregular heart rhythms (arrhythmias)
    • Evidence of past heart attacks
    • Signs of reduced blood flow (ischemia)
    • Strain patterns that suggest an enlarged heart

Your provider may also order blood tests (including thyroid function and cholesterol levels) and possibly advanced imaging (such as cardiac MRI) depending on your situation.

Treatment of an Enlarged Heart in Grand Rapids

Treatment depends on the underlying cause of the enlarged heart and how severe it is. Care is usually coordinated between your primary care provider and a cardiologist.

Addressing the Underlying Problem

Treatment may include:

  • Lifestyle changes

    • Stopping smoking
    • Reducing alcohol intake
    • Adopting a heart-healthy, low-fat, low-salt diet
    • Losing weight if overweight or obese
    • Regular cardiovascular exercise as recommended by your provider

  • Medications

    • To control high blood pressure
    • To reduce fluid buildup (diuretics)
    • To slow the heart rate and reduce strain (beta blockers)
    • To relax blood vessels and lower blood pressure (ACE inhibitors, ARBs)
    • To manage cholesterol
    • To treat thyroid disease or other contributing conditions

  • Procedures or surgery

    • Repairing or replacing faulty heart valves
    • Opening blocked coronary arteries (angioplasty and stenting)
    • Bypass surgery for severe coronary artery disease
    • In advanced cases, devices such as pacemakers, defibrillators, or even heart transplant (usually at larger regional centers)

Ongoing Monitoring

  • Regular medical check-ups to make sure treatments are working
  • Repeat echocardiograms or other tests as needed
  • Close follow-up with a cardiologist if you have cardiomyopathy, heart failure, or significant valve disease

Lifestyle Tips for Heart Health in Grand Rapids

Because Michigan’s climate and lifestyle can affect heart health, consider:

  • Staying active year-round
    • Use indoor facilities (local gyms, community centers, or home equipment) during winter.
    • Aim for at least 150 minutes of moderate exercise per week, if approved by your doctor.
  • Heart-healthy eating
    • Focus on fruits, vegetables, whole grains, lean proteins, and healthy fats.
    • Limit salt, especially if you have high blood pressure or heart failure.
  • Managing winter risks
    • Use caution when shoveling snow; this can put sudden strain on the heart.
    • Dress warmly to avoid cold-induced blood vessel constriction.
  • Regular screenings
    • Blood pressure checks
    • Cholesterol and diabetes screening
    • Annual wellness visits

The Kent County Health Department and Grand Rapids Public Health resources can provide community programs, nutrition guidance, and support for quitting smoking and managing chronic diseases.

When to Seek Help

Contact your doctor or a cardiologist in Grand Rapids if you notice:

  • New or worsening shortness of breath
  • Swelling in your legs, ankles, or feet
  • Frequent dizziness or fainting
  • Irregular heartbeat or strong palpitations
  • Unexplained fatigue

Call 911 or go to the nearest emergency room if you have:

  • Sudden chest pain or pressure
  • Severe shortness of breath
  • Fainting or near-fainting
  • Rapid, irregular heartbeat with weakness or chest discomfort

Key Points About Enlarged Heart (Cardiomegaly) in Grand Rapids

  • Older adults are at increased risk of having an enlarged heart.
  • In some cases, an enlarged heart has no symptoms and is found on routine testing.
  • Symptoms, when present, may include:
    • Fluid retention (swelling in legs, ankles, feet)
    • Shortness of breath
    • Dizziness
    • Irregular heartbeat and palpitations
  • Enlarged or “dilated” heart is one of the most common types of cardiomyopathy.
  • The most common symptoms of cardiomyopathy are shortness of breath and swelling of the ankles.
  • Early diagnosis and treatment through Grand Rapids healthcare providers (Spectrum/Corewell Health, Trinity Health, Metro Health, Mercy Health) can help prevent complications and improve quality of life.

If you live in the Grand Rapids area and are concerned about heart disease or an enlarged heart, schedule an appointment with your primary care provider or a local cardiologist for evaluation and personalized care.