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"How Big Can A Dilated Heart Get From Stenosis?" Asks Julie

Written By: Adam Pick, Patient Advocate, Author & Website Founder
Medical Expert: Kevin Accola, MD, AdventHealth, Orlando, Florida
Page Last Updated: June 7, 2025

Here's an interesting question from Julie about heart valve stenosis and enlarged hearts.

Julie writes to me, "Adam - Like you, I was diagnosed with heart valve stenosis and an enlarged heart. I'm just curious. How big can a dilated heart get before failure? 20% bigger? 50% bigger? Any thoughts? Thanks, Julie"

I wanted an expert opinion for Julie's question, so I contacted Kevin Accola, M.D., one of the leading heart valve surgeons from AdventHealth Cardiovascular Institute (formerly Florida Hospital). (As you might recall, Dr. Accola has operated on several patients, like Scott Nieman, that regularly visit this blog.)

Here is Dr. Accola's response:

Cardiac size per se is very dependent on numerous patient factors including the size of the patient, the severity of aortic stenosis and other cardiac factors such as coronary artery disease. So, it is not so much the interval change in size that would determine failure, but rather the underlying cause of the enlargement - in this case the aortic stenosis. If the heart is beginning to compensate by enlarging, I typically recommend aortic valve replacement to allow the heart a better chance of returning to normal size.

I hope Dr. Accola's comments help all of us learn more about enlarged hearts. So you know, this condition is medically referred to as dilated cardiomyopathy. According to the Texas Heart Institute, it is one of the most common forms of heart muscle disease. One of the key risks of dilated cardiomyopathy is congestive heart failure.

Thanks to Julie for emailing me her question and thanks to Dr. Accola for sharing his clinical expertise!

Written by Adam Pick - Patient & Website Founder

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

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