Q: A recent Xray (chest) shows that my heart is larger than normal. Pl give possible explanation and what practical steps to take. I am in Hong Kong and wonder if any wynites is a heart specialist here that I could see. I am retired and 76 years old. Thank you
A: A heart is enlarged because it has to do more work. This is akin to body building. Muscles “enlarge” when body builders pump iron.
Without knowing your background training & past medical history, I’ll try to list some general etiologies using as many laymen’s terms as possible.
What might be the causes?
1. High blood pressure.
2. Structural damage: leaking heart valves,(rheumatic heart disease, calcification/stiffness), damage by infections/poisons/medications, etc.
4. Hormonal: eg. hypothyroidism.
5. Rarely, hereditary (cardiomyopathy).
You can also check internet search engines for: cardiomegaly” , “cardiac hypertrophy” or simply “enlarged heart”.
I don’t know any cardiologist in HK, but I’ll check with Mr. Anthony Ho & see if he knows any WYK alumni who are practicing cardiologist in HK.
(Q) To follow up my case because it may have a general interest. I consulted a heart specialist about my enlarged heart. After ultrasound and other tests he confirmed that indeed the wall of my heart is thickening. In consideration of the medicine I have been taking for 17 years, Adalat XL, this specialist pointed out that it is a very old medication with the possible effect of helping the wall of the heart to thicken. Or at least not preventing it to do so. There are much better medicines now, with almost no side-effects, like Cozaar. So I am now on this medicine.
The point is that I know a lot of people taking Adalat in Canada. In fact, I had been requesting my family doctor in Toronto to make a change in the past three years. But he simply said Adalat was OK.
I am told that very few doctor in Hong Kong prescribe Adalat for high blood pressure.
It would be important for us to know which is which. Thank you
(A) Adalat belongs to a class of anti-hypertensives called calcium channel blockers(CCB). While CCBs are still used selectively as second or third line treatment, even Canadian doctores are using more ACE (angiotensin converting enzyme) inhibitors such as Coversyl, and now ACE II inhibitors (such as Cozaar).
What a family doctor prescribes depends on how comfortabe he/she is with a particular class of antihypertensives, and whether he/she has time to attend continuing medical education to keep up with new medical advances.
That is why I always recommend to patients that if he/she doesn’t feel comfortable with the treatment received, he/she should always ask (albeit tactfully) for a second opinion.
instead of: “ACE II inhibitors (such as Cozaar), it should read:”ACE II inhibitors (a.k.a. Angiotensin II Receptor Blockers or ARBs such as Cozaar).