Cardiomegaly
| Classification according to ICD-10 | |
|---|---|
| I51.7 | Cardiomegaly |
| ICD-10 online (WHO version 2019) | |
The term cardiomegaly refers to an enlargement of the heart that is outside the norm. Cardiomegaly is not an independent clinical picture, but a secondary organ change that can be traced back to other underlying diseases.
A very large enlargement of the heart is called cor bovinum ("ox heart") in clinical parlance, regardless of cause and stage .
causes
Cardiomegaly can result from increased physiological stress or from pathological processes. Triggering factors or diseases are z. B .:
- extreme physical training ( sports heart )
- Arterial hypertension
- Valvular heart disease
- Fallot tetralogy
- Cardiomyopathies
- severe anemia
- Hyperthyroidism
- Hemochromatosis
- Amyloidosis
- Acromegaly
- diphtheria
- Pompe disease infantile
Symptoms
As long as a critical value is not exceeded, cardiomegaly can be asymptomatic and can only be discovered as an incidental finding on the X-ray. At an advanced stage, it manifests itself in cardiac arrhythmias and the signs of heart failure .
diagnosis
Cardiomegaly can be diagnosed by echocardiography or by x-ray ( chest x-ray ). The heart-thorax quotient (CTR) in the p. a.-projection . If it is greater than 0.5, it indicates cardiomegaly. However, this numerical value should always be assessed in context, as it is e.g. B. can also be increased in severe obesity , pregnancy , ascites and funnel chest.
When X-raying with mobile devices ( ap projection ), the heart may appear enlarged due to the projection. A sign of cardiomegaly is when the heart silhouette touches the left chest wall.
In malformations that are associated with a greatly enlarged right ventricle, such as the Fallot tetralogy, there may be a visible protrusion ( Voussure , also called "heart hump") of the ribs or chest wall to the left of the sternum.
In dogs, the size of the heart is determined using the Vertebral Heart Score .
Individual evidence
- ^ W. Pschyrembel: Pschyrembel. de Gruyter Verlag, ISBN 3-11-007018-9 .
- ^ H. Lippert: Textbook anatomy. Urban & Fischer-Verlag, 2006, ISBN 3-437-42362-2 , p. 227ff. (on-line)
- ^ Klaus Holldack, Klaus Gahl: Auscultation and percussion. Inspection and palpation. Thieme, Stuttgart 1955; 10th, revised edition, ibid 1986, ISBN 3-13-352410-0 , pp. 58 and 99.
