Alluding to someone’s “big heart” is a common metaphor for referencing either their kindness, courage or tenacity. Individuals with a penchant for devoting their resources to those who are less privileged are often said to be “all heart,” while undersized competitors in sporting events are frequently said to have hearts even bigger than their own bodies — a literal impossibility, and an unsettling image every bit as creepy as the second Lego movie’s shape-shifting alien queen made it look.
On the other end of this spectrum, I recall reading that professional wrestler Eddie Guerrero — a virtuoso talent in the wrestling industry — died of heart disease caused by a heart far larger than that of an ordinary man at the time of his death. Furthermore, this extra large heart was described as a telltale indicator of anabolic steroid abuse. It’s a sobering thought to consider that Guerrero, a 5-foot-8 wrestler who epitomized the “all heart” label, may have met his demise as a result of having a heart that was decidedly too large.
So which one is correct? Is an authentically big heart a beneficial trait, or does it pack the potential to relegate someone in possession of a tank-like ticker to a premature demise?
How does someone get an enlarged heart in the first place?
The technical term for possessing a large heart is “cardiomegaly,” and it can be caused by many factors. Thankfully, none of them can be directly linked to caring about anyone or anything to an outsized extent.
The simple answer is that an enlarged heart is caused by any set of circumstances that prompts it to consistently work harder. The heart is simultaneously a muscle and an organ, as it’s composed of cardiac muscle fibers that function much the same way as other muscle fibers in the body. An average human heart is 5 inches by 3.5 inches by 2.5 inches, but when the capacity of its muscles is stretched to the limit, the fibers of those muscles develop microtears. In response, blood floods to the region to repair the muscle, and the muscle grows back larger and thicker. Even a half an inch increase in heart size can be construed as an atypical and harmful enlargement.
Another cause of an enlarged heart is the intentional abuse of potentially harmful substances like drugs and alcohol. Both can elevate the challenge involved in pumping blood throughout the body, and this causes the heart to expand and enlarge to hold additional blood.
There’s also a much more boring answer — i.e., an enlarged heart can be caused by something as ordinary as hypertension (or high blood pressure), which forces the heart to work harder over long stretches of time, and thereby causes the left ventricle to thicken due to its increased workload.
Finally, an enlarged heart may be the by-product of a host of different diseases and conditions — namely, congenital heart disease, cardiomyopathy, anemia, thyroid disease and even obesity, which often tasks your heart with pumping blood to more tissues than the body has been optimized to carry.
Doesn’t exercise cause my heart to work harder as well?
Actually, regular exercise — which is typically of short duration relative to the remainder of a 24-hour day — strengthens the heart in a way that enables it to pump blood with less effort. It also reduces the stiffness of blood vessels, making it easier for the blood to flow through them. As a result, average blood pressure is lowered, and the heart does less work in the long run.
How would I know if I have an enlarged heart?
If you’ve been diagnosed with high blood pressure or you’re doing a fair amount of drinking, there’s a chance that your heart is trending in an inflationary direction.
In terms of traceable symptoms, it’s a little more complicated. First, many people who suffer from cardiomegaly exhibit no symptoms of any kind. Second, when symptoms are present, they commonly involve dizziness, fatigue, shortness of breath and other physical ailments that are pretty common. And so, it’s difficult to know if your heart has become enlarged unless you chase down a doctor and solicit a diagnosis from them.
All of which is to say, being all heart or bighearted is a great thing metaphorically, but certainly something you never want to hear from a physician in a medical setting.