heart enlargement

[Tomred]

hi everyone, can someone enlighten me , do rate control drugs or rythym control drugs or both keep enlargement at bay.

[Autumn_Leaves]

Reversing enlargement depends on the underlying cause. When some people are treated for valve disease their affected heart chambers may reduce in size, but that is major surgery. AF can be a consequence of left atrial enlargement due to valve prolapse, so repairing or replacing the valve may bring about improvement. That has definitely been reported by people on the BHF forum.

Whether controlling AF with rate and/or rhythm control drugs prevents existing enlargement getting any worse, that might be a question to ask your cardiologist. Maybe other people on this forum might be able to share their own personal experiences. It would be very useful information.

[Tomred in reply to Autumn_Leaves]

Thank you autumn leaves

[BobD Volunteer]

Generally speaking if your rate is well controlled and AF is your only problem then the left atrium may well return to a more normal size.

[Tomred in reply to BobD]

thank you Bobd

[SeanJax]

Atrium enlargement is due to hight heart rate so it is critical to keep the HR down during Afib episodes. Enlargement will cause valve leak, which in turn causing more enlargement. It is a vicious cycle. So the bottom line, mimimum Afib episodes and lowest possible HR during these episodes to keep atrium enlargement at bay. Age plays a big role here too. Almost all people above 60-70 have some kind of valve leaks and some degree of enlargement. It is called aging process. We have to live with it.

[Tomred in reply to SeanJax]

Thank you sean.

[Tomred in reply to SeanJax]

Thank you Sean .

[DevonHubby1]

Wife was diagnosed with AF back in 2018 and the echo then showed an enlarged left atrium. She was put on anticoagulants and beta blockers. This year she went into persistent AF do they did another echo. No further enlargement of left atrium so meds have halted that.

[Tomred in reply to DevonHubby1]

Thank you devon .

[Ducky2003]

Hi. AF has caused my left atrium to enlarge now resulting in being on the list for a mitral valve repair......... the enlargement has pulled the annulus out of shape. It does have the capacity to shrink back as they thought mine may have as I was feeling so well, but unfortunately, a scan showed otherwise. I was on Diltiazem and Amiodarone but still having quite symptomatic near constant episodes of AF until another cardioversion 15 months ago stopped it.

If you have any enlargement, I hope you are being monitored and that your meds are doing their job.

[Tomred in reply to Ducky2003]

Just had phone call from consultant a month or two back , thats all no tests, just contemplating reducing or stopping dronenederone, want to see and weigh up answers on here first, but will still take 1. 25 bisoprolol, thank you for reply .

[Dudtbin]

i had enlargement due to AF, am on entresto and spironalactone. The TOE I had showed heart back to normal size still got leaky valve but told its normal for my age .

[Tomred in reply to Dudtbin]

Thank you Dudtbin.

[Barb1]

I can only give my own experience. An x-ray to check on a possible rib fracture showed that I had an enlarged heart, later diagnosed as Dilated Cardiomyopathy. The AF was then discovered and treatment for that with meds, DC's and ablations caused my heart to go back to almost normal size albeit being as my EP said , 'a bit stiff.' Since then my AF has become permament resulting in a Pace and Ablate. So although the AF is doing its own thing, it doesn't seem to affect the size of the heart, so far.

Hope that helps.

[Tomred in reply to Barb1]

Thank you Barb.

[Barb1 in reply to Tomred]

Good luck

[JOY2THEWORLD49]

Hi

Um I have an enlarged heart. ECHO showed it.

So no Flecainide (structurally your heart needs to be perfect), no cardioversion, no ablation.

Just control of H/R and BP.

I believe leaving me 2 years 3 months with H/R Day at rest 187 on Metoprolol and 156 Bisoprolol uncontrolled caused it.

Introducing me to CCB Diltiazem 120mg AM changed my life to moving towards normality.

A private H/Specialist carefully decided, I needed to be controlled. H/R now 60s Day and always 47 avge night. BP controlled by 2.5 Bisoprolol PM.

I'm hoping that another ECHO now may show that my heart is no longer enlarged.

cheers JOY. 74. (NZ)

[Tomred in reply to JOY2THEWORLD49]

Thank you Joy.

[Ppiman]

I would like to think so since the heart enlarges when other things go wrong, so keeping those at bay must surely help.

Heart enlargement seems to arise for several reasons including even pregnancy and body size to meet the changing demands for oxygen. I’ve read that losing lots of weight reduces the size and output of the heart, similarly. I read an excellent study once that showed how when the heart muscle and cells become “stretched” (as in an enlarged heart), it’s more prone to fibrillation. It’s also true that the heart cells can’t replace themselves or increase in number so must be somehow elastic in order to swell. That natural elasticity will likely become damaged in certain heart diseases or even advancing age and wouldn’t necessarily be reversible.

I know that AF can cause atrial enlargement, but what I’ve read seems to be that doctors are unsure if this is chicken or egg.

Also, uncontrolled tachycardia can enlarge the ventricles and weaken the valves, too, so keeping that at bay must surely prevent enlargement of those? Similarly high blood pressure and atrial disease from things like atherosclerosis and diabetes can do the same.

This article seems useful:

myheart.net/articles/what-i....

Steve

[Tomred in reply to Ppiman]

thank you Ppiman

[JOY2THEWORLD49 in reply to Ppiman]

Hi

Interesting Steve.

But when I was told a former xray for spine showed heart just in 'normal range' this Heart Specialist said that the ECHO is best as it measures etc. And my enlarged heart was behind.

I think after the stroke with AF and then the shadow on thyroid, my triage team didn't think about doing any procedures until prper diagnosed and cancer removed.

Then by then - 4 months later, all not been forgotten until at 1 year 4 months and cursing metoprolol for breathlessness and no energy .... no followup so I asked for a heart specialist at 1 year 4 months. Then the ECHO, ECG and 24-hr monitor was done.

The ? why is there no followup to check meds and how patient surviving.

I'm now coming up to 4 years since the stroke but I'm read 5 years is the most important milestone! for surviving.

I find 60s H/R Day is best for me. Night avge stays at 47 sleeping whatever the meds.

cheri JOY. 74. (NZ)

[Ppiman in reply to JOY2THEWORLD49]

I think 5 and 10 year dates are milestones. I strongly suspect you are a natural survivor!

Steve