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Pulmonary hypertension is high blood pressure within the artery that connects the lungs and heart. It forces the heart to work harder to transfer blood between the heart and lungs, which may lead to an enlargement of the right side. Thyroid problems, whether they involve an underactive or overactive thyroid, can cause a heart to enlarge.
Chronic, untreated anemia can also cause an enlarged heart over a long period of time can cause the heart to enlarge, although it is relatively rare. Enlarged Heart Symptoms. Some patients with an enlarged heart report no symptoms of the condition.