Enlarged Heart: A Patient’s Journey
Written by: Marcos Otero, Retired Physician Associate
Our Patient
Patient: Javier Alejandro Pérez
Location: Mexico City, Mexico 🇲🇽
Diagnosis: Cardiomegaly (Enlarged Heart)
Background
Javier Alejandro is a 50-year-old taxi driver who has spent more than two decades working long hours on the congested streets of Mexico City. Despite a history of hypertension, he rarely visits the doctor, as his demanding schedule and the need to provide for his family of five leave little time or money for healthcare. In recent years, Javier has noticed increasing fatigue, which he always attributed to work-related stress and the relentless traffic of the city.
Presentation of Symptoms
One evening, after an especially exhausting day, Javier experienced chest pressure along with shortness of breath. Concerned, his family took him to the emergency room, where a chest X-ray revealed a visibly enlarged heart.
Key Symptoms
Persistent fatigue
Chest pressure or discomfort
Shortness of breath, especially with physical exertion
Swelling in the lower extremities (edema)
Occasional dizziness
Diagnosis & Treatment
An echocardiogram and electrocardiogram confirmed that Javier had cardiomegaly, likely caused by his long-standing, uncontrolled hypertension. Tests also showed early signs of heart failure.
Treatment Plan
Medications: Javier was prescribed beta-blockers, ACE inhibitors, and diuretics to control his blood pressure and reduce the strain on his heart.
Lifestyle Changes: He was advised to reduce salt in his diet, lose weight, and limit alcohol consumption.
Regular Medical Follow-ups: His doctor stressed the importance of frequent check-ups to monitor his heart function.
Complications
Due to his demanding work schedule and inconsistent access to medication, Javier has struggled to follow his treatment plan. Additionally, the financial pressure of supporting his family has made it difficult for him to prioritize his health.
Cultural and Family Support
Javier’s wife and children worked together to prepare healthier meals and help him manage stress. They also encouraged him to reduce his work hours to focus on recovery. As a show of community support, a local fundraiser was organized to help cover some of his medical expenses.
Life Today
Positive Outcome: Javier has successfully managed his condition through lifestyle changes, medication, and a more balanced work schedule. He now spends more quality time with his family and feels more energetic.
Negative Outcome: Without proper adherence to treatment and recommendations, his heart could continue to enlarge, increasing the risk of severe heart failure and life-threatening complications.
