Several conditions can lead to cardiomegaly. The most common are high blood pressure, coronary artery disease (CAD), and past heart attacks. Valve problems and inherited heart disorders also contribute. Other causes include heart muscle disease (cardiomyopathy), thyroid imbalances, pulmonary hypertension, and chronic illnesses like kidney disease or diabetes. Lifestyle factors—such as long-term alcohol use or certain infections—can also play a role.

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