DEAR DR. DONOHUE: Can anything be done for an enlarged heart?

The doctor told my son, age 40, that the left side of his heart is enlarged. He wasn’t sure why it happened. They have not found a blockage, but he is having a catheter examination of his heart arteries in a few weeks. He had an infection in a wisdom tooth. At that time, he had an irregular heartbeat. The infection cleared up. Then they discovered the enlarged heart. He has no symptoms — no chest pain, no shortness of breath. What can be done about this? — E.B.

ANSWER: Hearts enlarge for both good and bad reasons. Athletes often have larger-than-normal hearts. The heart is a muscle, and it responds to exercise in the same way other muscles do: It grows. An athlete’s heart is a good thing. It pumps more blood with each beat, so it beats more slowly than the average heart.

High blood pressure is the greatest cause for left-sided heart enlargement. It’s the left side of the heart that pumps blood to the body. High blood pressure makes the heart beat with greater effort. For a time, the heart can continue to pump against high pressure by getting bigger, but there comes a point when it can’t grow any larger. At that point, the heart fails. Lowering blood pressure is the answer to this kind of heart enlargement.

Leaky heart valves are another cause of heart enlargement. Cure for this is often replacement or surgical correction of the valve.

Cardiomyopathies — inherited conditions where the heart grows big — are another reason why heart size increases. These conditions are treated with medicines or by removing excess heart tissue. Hearts also become bigger because they become flabby. They have become so weak that they can’t get rid of all their blood. The retained blood stretches them out of shape. Medicines often can restore a more-forceful beat, and the heart shrinks back to a more normal size. Your son’s wisdom tooth infection isn’t a likely cause of his heart enlargement.

Advertisement

DEAR DR. DONOHUE: I have a problem with altitude. I live at 2,150 feet in the Sierra foothills. When I go above 4,500 feet, I get cramps in my legs and feet. I am in good health and exercise daily. I have had plenty of tests done, including a stress test and wearing a heart monitor. Everything checks out well. I could use some help. — J.P.

ANSWER: If the muscle cramps come from the altitude, you can do many things that permit tolerance to higher-than-normal elevations. Rapid ascent to heights of 8,250 feet (2,500 m) can get many in trouble with mountain sickness or high-altitude pulmonary edema (fluid in the lungs). Most people tolerate an ascent to 5,000 feet (1,667 m) without trouble. You might not be one of them.

Ascend to your destination slowly, taking two or even three days to reach it. If you go up more rapidly, descend to a lower elevation to sleep. Limit your physical activity in the first few days. Drink plenty of fluids; high altitudes dehydrate people. Wear warm clothes; for each 1,000 feet of elevation, temperature drops 4 degrees Fahrenheit.

Ask your doctor if you can take Diamox, a mild diuretic, that helps people cope with heights.

DEAR DR. DONOHUE: I have seen well-meaning parents pick up a toddler by the child’s hands and swing the child about in play. It makes me cringe. I heard of something called skip gutter syndrome that injures a child’s bursa from doing this. Am I overreacting? — C.G.

ANSWER: I’m not acquainted with that syndrome. I do know that lifting a child up by the hands can cause the ligament that holds together the two heads of the forearm bones to slip off the bones. It’s a little like having an elbow dislocation. When it happens, it is painful, and the child can’t use the arm well. A doctor has to maneuver the ligament back into place.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


Only subscribers are eligible to post comments. Please subscribe or login first for digital access. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.