The symptoms of cardiomegaly may vary depending on the underlying cause and common symptoms include dyspnea and fatigue. A careful history is important to ascertain the underlying cause of cardiomegaly. The patient should be asked if there is a history of hypertension, rheumatic heart disease that would cause valvular heart disease, congenital heart disease, alcohol abuse, or a history of symptoms suggesting ischemic heart disease.

Depending upon the underlying cause of cardiomegaly, the following symptoms may be present:

• Cough
• Dizziness
• Dyspnea
• Fatigue
• Palpitations
• Pedal edema
• Syncope

In the patient with cardiomegaly, the patient should be asked if there is a history of the following:

• Hypertension
• Rheumatic fever or known valvular heart disease
• Alcohol abuse or recreational drug use such as cocaine
• Chest pain to suggest ischemic heart disease
• Congenital heart disease