DEAR DR. DONOHUE: Will you inform me about big hearts or enlarged hearts? I have one. — P.

ANSWER: It’s hard to imagine why the heart was picked to represent romance. It isn’t terribly romantic. It’s a muscular sack that pumps blood. The right side of the heart pumps blood to the lungs to pick up oxygen. The left side of the heart pumps blood to the body to deliver the oxygen it picked up. The reasons for heart enlargement are many.

Hearts of well-trained athletes grow bigger, because, like any other muscle, the heart responds to exercise. This is good heart enlargement. An athletic heart can pump more blood with each beat and, therefore, needs fewer beats to get the job done.

High blood pressure makes the heart grow larger. The high pressure is an obstacle to blood pumping. The heart has to exert more force to circulate blood. It enlarges in order to do so. Unless blood pressure is lowered, enlargement cannot continue indefinitely. Untreated high blood pressure makes the heart give out.

Heart failure leads to a larger heart. The problem lies with flabby heart muscle, because the arteries supplying the heart are clogged. The heart muscle isn’t being nourished. The heart cannot pump with force. It stays filled with blood and stretches out like an overinflated balloon. Treatment here centers on clearing out the obstructed heart arteries and providing medicines for a stronger beat.

Heart valve disease causes heart enlargement.

Cardiomyopathy, a disease (“pathy”) of heart muscle (“cardiomy”) is another condition that makes the heart bigger. Sometimes it’s a hereditary condition. Sometimes it results from an infection of the heart muscle. Sometimes strange materials are deposited in the heart muscle, like iron or the protein amyloid.

The point to take home about heart enlargement is that finding the cause is necessary in order to find the cure.

DEAR DR. DONOHUE: After reading your article on constipation, I felt compelled to tell you of a solution for my husband’s longstanding constipation. His sister told him to go to a health-food store and buy wheat bran. The saleswoman brought us a 1-pound bag for less than $2. Every morning, my husband puts one heaping tablespoon onto his cooked oatmeal and stirs it into the oatmeal. Regularity isn’t even discussed anymore. It’s become a normal thing. The cost and ease of taking it made us believers. — C.B.

ANSWER: Bran is fiber and is a good constipation treatment. It keeps water in the undigested food residue. That makes for ease of elimination.

Do you know what bran is? It’s the outer coat of a grain, the stuff removed when refining grains. Whole grains are grains that retain their bran coat.

The booklet on constipation offers some other remedies for this exceedingly common condition. Readers can order a copy by writing: Dr. Donohue — No. 504, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: A short time ago, you dealt with the use of Tums for its calcium. How does the Tums know whether it’s being used for calcium or as an antacid? — C.D.

ANSWER: Tums doesn’t know why it’s being taken. It’s not high on brain power. Tums is calcium carbonate. The calcium part of Tums goes to bones. The carbonate part of Tums deals with stomach acid.

DEAR DR. DONOHUE: I am considering Juvederm injections. What do you think of it? — K.M.

ANSWER: Juvederm is hyaluronic acid, stuff that has many body functions. It’s sort of like collagen. Injections of it smooth wrinkles and creases. The effects last from six months to a year. It’s FDA-approved. I haven’t heard anything bad about it. You have to go into this knowing the cost. That’s something you must discuss with your doctor.

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.

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