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Dauther's X-ray shows enlarged heart
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Dauther's X-ray shows enlarged heart

About a month ago, my wife mentioned to our family doctor that our 3 year old daughter seemed to be breathing a little harder then normal. As a precaution, the doctor ordered a chest x-ray. The x-ray came back showing an enlarged heart. Our doctored ordered an ECG for our daughter and referred her to a pediatrician. The ECG came back normal, and in the meantime, our daughter's breathing seemed to return to normal.

During the visit with the Pediatrician, another ECG was conducted (which also came back normal), and the Pediatrician listened to our daughter's heart and said everything sounded fine. He suspected that the problem was a bad x-ray, and ordered an another one, which we had done on Monday.

Yesterday, we received a call from the Pediatrician saying that the second x-ray still showed an enlarged heart. He's referring us to a Pediatric Cardiologist and mentioned that my daughter may have Cardiomyopathy.

Of course, as a concerned father, I began researching Cardiomyopathy and what I'm seeing is scaring the hell out of me. I've been reading about high mortality rates and low 5 year survival statistics.

I'm not sure how long until we get the appointment with the Cardialogist, and the wait is killing me. Is my daughter, who seems completely healthy, really as sick as I've been reading? Could it be that both x-rays were wrong? If not, could the enlarged heart be something other then Cardiomyopathy?

If anyone has any information they could share, I'd really appreciate it.

Thank you.
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773637_tn?1327450515
Dear Padlock,

Before even being concerned that there is any specific disease, the most common reason that I see for a large heart on chest X-ray is an incomplete inspiration during the study, which makes the heart look large and the lungs look small.  Therefore, I would recommend not considering any disease processes before finding out if there is anything actually wrong.  I find that it is not helpful, and often more anxiety-provoking for families, to discuss potential lists of problems without having an idea if the original test was correct, or not.  And, without seeing the film, I cannot say if the heart is truly enlarged, or it is an artifact of poor radiologic technique.  A pediatric cardiologist will assess history, examination, an ECG, and the X-rays.  If it cannot be sorted out, an echocardiogram (cardiac ultrasound) can be performed to determine whether the heart is truly enlarged, or not.  If it is enlarged, then your cardiologist can review various reasons with you based on the findings.
8 Comments
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Avatar_n_tn
Just a quick follow up on my last post, here are the results from her second x-ray:

The cardiothoracic ratio is 103/14.9 consistent with cardiomegaly but no significant abnormality is seen within the pulmonary vasculature and no evidence of pulmonary edema is seen. Furthur evaluation by echocardiography is recommended if it has not been performed. The lungs are clear and no pleural disease is identified.
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Avatar_m_tn
I am not a doctor.

The x-ray gives more of a suggestion of a cardiomyopathy than a definitve answer.  The x-rays are one part of the puzzle.  Two normal ECGs are two other pieces.  The doctor saying that everything he hear is normal is another piece.  The pediatric cardiologist will have the ability to help see if she does have a cardiomyopathy  and if so, how to properly treat it.  The treatment of cardiomyopathies has evolved a great deal over the last 5-10 years.

The two normal ECGs read as normal.  If your daughter is running up and down hills and stairs all the while screaming at the top of her lungs, then most likely she doesn't have a cardiomyopathy.  If she gets gassed doing basic things like brushing her teeth or walking across the room, then you a little bit more concern may be warranted.  The internet has a lot of information, unfortunately how much of it that pertains to your situation is unknown.  There are a few different cardiomyopathies (they have different treatments) as I'm sure you read about  ( and I don't read EKGs) but I don't think that they give normal ECGs.  They may do a heart echo which uses ultrasound to see how well the heart squeezes and how well the valves work.  If she is acting normal for a 3 year old, then the probabilities are that she has a normal heart.  I hope this helps.

Good luck
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Avatar_n_tn
Thank you EchoTech. I really appreciate you taking the time to respond.
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Avatar_m_tn
no problem.  I know waiting to get an answer is something that all parents struggle with.
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Avatar_n_tn
Thanks for the advice Doctor Boris. I will try to take it to heart (no pun intended).
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88793_tn?1290230777
My chest X-ray also showed an enlarge heart.  ECG split out also mentioned enlarge heart but my doctor cross it out.  Echo showed normal size.  Heart sound normal too.  

It all depends by your doctor and a doctor who wrote the report.  My cardio told me, the heart is surrounded by a thick layer of fat.  These fat take account into the size of the heart.  May be if you change to a different radiology then the result will surprise you.  

I have seen some people wrote that born with enlarge heart but it is nothing wrong.  Some, the whole family member with enlarge heart but their hearts were healthy too.

Young daughter like that, definitely will scare the parents.  Will take the doctor to concern as well.  Take care.
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Avatar_f_tn
Have you seen the pediatric cardiologist yet? How are things going at this point? My daughter was diagnosed with a cardiomyopathy at 6; I know how scared we were at first!
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