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.
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
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!
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.
Thanks for the advice Doctor Boris. I will try to take it to heart (no pun intended).
no problem. I know waiting to get an answer is something that all parents struggle with.
Thank you EchoTech. I really appreciate you taking the time to respond.
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.