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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.
Sometimes the heart enlarges and becomes weak for unknown reasons (idiopathic). A heart condition you're born with (congenital), damage from a heart attack or an abnormal heartbeat (arrhythmia) can cause your heart to enlarge. Other conditions associated with an enlarged heart include: High blood pressure. Your heart may have to pump harder to deliver blood to the rest of your body, enlarging and thickening the muscle. High blood pressure can cause the left ventricle to enlarge, causing the heart muscle eventually to weaken.