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Patients with cardiomyopathy, a stiffening and thickening of the heart muscle that weakens it, may develop an enlarged heart as it labors to pump an adequate supply of blood to the body. Coronary artery disease, in which plaque in the arteries interferes with the flow of blood, can cause the heart to enlarge.
CHF: The cause of the enlarged heart is what dictates the outcome from such a situation. If you have a very weak heart with congestive heart failure and both sides of the heart malfunctioning to cause this, that is very serious. If you have some more benign situation which is also possible could be less serious.