Chest x-rays and electrocardiograms are common in diagnosing an enlarged heart. A chest x-ray allows doctors to evaluate the cardio-thoracic ratio to determine if the heart is too large. Recording the organ's electrical activity via electrocardiogram testing detects problems with rhythm and determines whether damage to heart muscles has occurred from "silent" heart attacks. Echocardiograms monitor sound waves produced by a beating heart and assess the condition of the four chambers. In some cases, doctors may also want to do a cardiac catheterization to obtain a sample of the heart's tissues to look for signs of infection, inflammation, or abnormal cells. This information may help determine the cause of an enlarged heart.

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