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Enlarged Heart in Children

Enlarged Heart

An enlarged heart in children can be a symptom of several types of medical conditions. All of them require prompt medical treatment.

Possible Causes of Enlarged Heart in Children

There are a number of conditions which feature symptoms that include an enlarged heart, such as the following:


When pericardium (the sac surrounding the heart) is irritated, it causes swelling. Symptoms of this condition include:

  • Sharp pain in the center or left side of the chest
  • Fever
  • Dry cough
  • Swelling in the abdomen or lower extremities
  • Shortness of breath when lying down
  • Fatigue or weakness

Pericarditis can be acute (lasting a few weeks) or chronic (symptoms persist for six months or longer). This condition is treated with a combination of bed rest and medications to reduce swelling. When the pericarditis is caused by fluid around the heart, a procedure to drain the area may be performed.


Myocarditis affects the walls of the heart muscle, causing inflammation. Possible causes of myocarditis include:

  • Chemicals
  • Infections
  • Medications
  • Radiation

When children develop myocarditis, the condition is usually caused by a viral infection. Influenza has been linked to myocarditis, but other Rubella, Rubeola and HIV can also cause the disorder.

A child with myocarditis may complain of flu-like symptoms, such as fever and fatigue. They may have cold hands and feet, with pale skin in these parts of the body. The child's urine input may decrease due to poor kidney function.

Some children with myocarditis have a cough, while others complain of chest pain while exercising. They may feel nauseous or experience pain in the abdomen. This condition can also lead to congestive heart failure and the face, hands and feet may swell as a result.

The inflammation associated with myocarditis will resolve itself with time, and doctors don't offer specific treatment for this symptom. Children with myocarditis are usually admitted to the intensive care unit of the hospital so that their condition may be monitored closely. Medications to help the heart pump more effectively or to keep the blood pressure in a normal range may be given.

Bed rest is an important part of the treatment process for myocarditis. The child may need to have his or her activities restricted for weeks or months during the recovery process. Resumption of normal activities is a gradual process.


Endocarditis is a bacterial infection affecting the heart valves. The bacteria may enter the body when the child is undergoing dental procedures or a minor surgical procedure. Symptoms of endocarditis include:

  • Chills
  • Fatigue
  • Fever
  • Muscle aches
  • Sore joints
  • Shortness of breath
  • Swelling of the abdomen and lower extremities
  • Night sweats

When endocarditis is diagnosed, it is treated aggressively with antibiotics. The medications are given by intravenous for between four and six weeks. In cases where the infection has damaged the heart valve, surgery may be necessary.

How Enlarged Heart is Diagnosed

The doctor will order a chest x-ray to get an idea of the size of the child's heart. The child may need to be seen by a pediatric cardiologist, who will take a detailed medical history and order an electrocardiogram (ECG). An ultrasound examination of the heart gives the doctor detailed information about the size of the heart, its chambers and valves.

Enlarged heart in children is not a common symptom. When it is detected, the treatment will depend on the underlying condition. Any time a child complains of chest pain, he or she should be seen by a doctor to determine the reason for the discomfort.

Heart attacks in children are rare occurrences, but they do occur. Chest pain is a symptom that warrants a trip to the closest emergency room to determine the cause. In most cases, the discomfort is caused by stress or strained muscles. This symptom may also be caused by one of the health conditions listed above, and all of them can cause enlarged heart in children.

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Enlarged Heart in Children