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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.
Accumulation of blood coming into the right side of the heart causes congestion and fluid accumulation in other parts of the body, such as the legs and the liver. Heart failure usually affects both the right and left sides of the heart to some degree. However, one side may be affected by disease more than the other.