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What causes an enlarged heart? What can be done about it?
Sent to Health Experts August 17 10:34 PM

My sister has received a diagnosis of a Stage 1 enlarged heart. What caused this?

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August 17 10:36 PM (1 minute and 44 seconds later)
         
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There are many causes. To start with, did she have heart murmur in childhood?
GP-MD -- Doctor (MD) -- 100% Positive Feedback on 5 Health Accepts
General physician since 1965
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August 18 12:14 PM (13 hours and 38 minutes and 24 seconds later)
         
Relist: No answer yet.
Will you please answer my original question: My sister has just received a diagnosis of an enlI aam arged heart, stage 1. What has caused this?
Customer (name blocked for privacy)
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August 18 1:19 PM (1 hour and 4 minutes and 55 seconds later)
         
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Hello. Thanx for responding.
Are you there now? There are quite a few causes.
What is her age?
Was there a heart murmur in childhood?
GP-MD -- Doctor (MD) -- 100% Positive Feedback on 5 Health Accepts
General physician since 1965
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August 18 6:40 PM (5 hours and 20 minutes and 56 seconds later)
         
Reply to GP-MD's Post: My sister is 80. She did not have a heart murmur in childhood, that we know of. Last summer she was bitten by a tick that was carrying Rocky Mountain Spotted Fever, and she was very very ill for awhile. She has not really totally recovered from that yet and I wonder if that precipitated her heart problem. She lives in southern Georgia and this was the first tick episode anyone there has seen. I understand that the Atlantic coastal states (of which Georgia of course is one) have many reported instances of Rocky Mountain Spotted Fever.

By the way, she saved the tick in a bottle and when she had to be hospitalized, the tick was sent to he CDC in Atlanta for analysis and back came the report that it was indeed a carried of RMS Fever.

I thought this might be pertinent information for you to consider. Thanks.
Customer (name blocked for privacy)
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August 18 10:41 PM (4 hours and 50 seconds later)
         
REPLIEDCheck Mark
Sorry -- we seem to be playing email tag instead of phone tag! Thank you for the update.
     Enlargement of the heart results from (a) thickening of the heart muscle, from (b) dilating of the heart chambers, or from (c) a combination of both. Stage I, of course, is the earliest mildest of the stages.
     The heart muscle ('myocardium') can be thickened by high blood pressure & by stricture of any of the 4 heart valves. Heart muscle thickening, 'hypertrophy', is less noticeable on xrays than chamber dilatation. Stage I (your sister) is mild, so hypertrophy is a possibility.
     The chambers can become dilated by back-leakage in a valve or by weakening of the myocardium to the point that it can no longer pump out enough blood. Dilated chambers produce the more pronounced cases of cardiac enlargement (maybe not your sister).
     The valve problems can be a birth defect, can be caused by rheumatic fever, or can occur as calcium deposits which accumulate w/ age ('calcific aortic stenosis').
     The heart muscle can be weakened directly (without involvement of valves) by alcohol ('alcohol mycardiomyopathy') & by infections of the heart muscle ('myocarditis').
     At your sister's age, many causes are ruled out (congenital heart valve disease, rheumatic fever, alcoholism). The most common cause for your sister's age-group is actually high blood pressure ('hypertension'), which puts a persistent strain on th heart muscle over a long period of time, producing a thickening of the heart muscle & then later gradual weakening of the heart muscle w/ dilatation. If she has a heart murmur, she might have 'calcific aortic stenosis', as this is commonly the cause in her age group.
     It is a known fact that some cases are due to infection of the heart muscle by several types of virus, known as viral myocarditis. Rocky Moutain Spotted Fever is not caused by a virus; however its cause, a germ known as Rickettsia, is a germ that shares features of both viruses & bacteria. It is quite possible that RMSF was involved in your sister's heart problem -- provided that hypertension & valve trouble are not involved.   By now the rickettsia germ is no longer in her body, but her enlarged heart could be an after-effect.
     There are medications to improve her heart by reducing load on the heart & to a lesser degree by strengthening the myocardium.
     Hope this is helpful & sorry about the delays. Feel free to add any questions or to share any other details of her illness.
GP-MD -- Doctor (MD) -- 100% Positive Feedback on 5 Health Accepts
General physician since 1965
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August 19 1:20 AM (2 hours and 38 minutes and 53 seconds later)
         
Reply to GP-MD's Post: Thank you very much for this information. I feel that my sister had a severe case of Rocky Mountain Spotted Fever. She had been ill for a number of days,thought she had a case of flu perhaps; friends recognized that she was sicker than she thought and arranged for the EMS to take her to the hospital. The doctor on duty had never seen a case of RMS Fever, but recognized that that was possibly what she had and began treating her for it. When information came back from the CDC confirming the diagnosis everyone was glad treatment had begun promptly. She was in the hospital for about 4-5 days, then released to go to her daughter's home in Atlanta for three weeks. (I live in Kentucky, so was of no help to her, in fact, did not know these details until later.)

She says her legs feel wobbly still, and she tires easily.

I just wanted to know if the heart condition might have been caused by the tick bite and its after effects, or at least have been exacerbated by it. Thank you for your patience and your reply. Dorothy Reeves
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August 19 1:37 AM (17 minutes and 18 seconds later)
         
You have helped me to understand more about her heart condition. I won't take up any more of your time, but appreciate your answer.
Customer (name blocked for privacy)
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