Does your heart go back to normal with treatment if it becomes enlarged?

[IsaacM7]

Hi there,
37yo male-thought I was healthy (thin, low blood pressure, low cholesterol, active). Had aFib/vFib/tachycardia for about 30 minutes last week and have never had anything like that. I freaked out and went to the hospital and they did a cardioversion (zapped me) to reset my heart and lose the arrhythmia. They put me on a beta blocker and a blood thinner. I also had a cardiac MRI done (with contrast). I met my cardiologist/electrophysiologist to go over MRI results. He said enlarged heart, Left atrial enlargement, and a leaking valve. He thinks that I should be on pills for a few months and see what changes. My question is can simply taking medicine fix any of this, or does it just prevent stroke/heart failure? Have any of you been diagnosed with something similar and come through it? I hate the med side effects, but obviously want to be around for my kids a while longer :) thank you!

[tacolino]

Hi there. Often the enlargement can improve significantly over a short to medium time. This is dependent on a proper cause being found for it and appropriate steps being taken to sort things. (EG Medication etc)

High BP causes enlargement over time, but yours was low BP ?

Its a fairly slow process, seeing if meds help with the valve etc.
you will probably be initially  taking meds for 12 weeks before review of things.

Its a real pain and yes the sides are always there. Sometimes the sides get better as you adjust to your tablets.
The beta blocker should help slow everything down a little
while the asprin or plavix blood thinner is a precautionary medication.

My story was that i had a hypertensive crisis, uncontrolled high BP.
It went crazy over time and it caused pretty serious failure.
The heart was enlarged, with severe impairment of pump function. EF was 15% !!
Once the BP was controlled it improved, my EF 12 weeks after meds started came bact to 45%
Everyones story is different, but trust your doc and try to be patient. . . . easier said than done!!!!!!!!!!!!!!!

[IsaacM7]

Thanks so much. I see a lot of people here who get the news and want answers immediately that only come in time. I think being patient is key. Thanks for the answers

[Ger57]

In many cases, if the cause of the enlargement is taken away,  the heart can recuperate at least partially.
If the enlargement has progressed very far, chances for recuperation become small.

There can be many reasons for the enlargement of your heart.
-If the enlargement is from a prolonged period of high blood pressure,  bp lowering medicine can help to fix it or stop it from further progressing.
-If the enlargement is a result of the leaking valve, medication will not solve the problem although it may help to stop progressing and alleviate symptoms. In that case a valve repair/replacement may be necessary
-Afib can be a result of the enlarged left atrium but can also be the cause of a dilated atrium. A betablocker to control Afib can help to avoid Afib's

Probably many other reasons can be found that caused your current condition. With the info you gave, if can not concluded which is right.

I suggest you talk to your cardiologist about the cause of the problem and the long term plan he/she has for you.

ps,
The side effect of medication often wears off after a few weeks, also there are a lot of alternatives if side effects persist, so do not worry too much about that.

[researcher09]

No one would have survived a 30 minute episode of VF.  It sounds like you had AF and you are getting the right care.  LA enlargement suggest that you may have had AF for a while and you weren't symptomatic, until the episode you described.  AF can happen from over training.  With some modification to your exercise routine and medications, the size will hopefully go back down towards normal size.  What is the size now?  Normal is in the 40s cm range.  If you have scarring from prior AF, it will be likely that you will have to ablate it in the future to get your exercise capacity back and the chance of a successful procedure goes up as your LA size gets back closer to normal range.  There are a number of atheletes that faced the same issue as you that blog on the LAF site so you probably want to check that out and get their take.