Cardiomegaly is an enlarged heart, which means that the heart size has increased. This, we most commonly judge by a physical examination or an x-ray. Cardiomegaly can occur due to the enlargement of the chambers of the heart or due to an increase in the muscle size referred to as hypertrophy of the cardiac muscles. X rays are images and can show radiolucent or opaque shadows. It is not possible to differentiate if the enlargement is due to hypertrophy with X Ray images, you may need an an ECHO to diagnose this.
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