{"id":193,"date":"2013-04-23T14:43:40","date_gmt":"2013-04-23T18:43:40","guid":{"rendered":"http:\/\/www.mynutriguide.com\/?p=193"},"modified":"2019-12-26T12:48:17","modified_gmt":"2019-12-26T17:48:17","slug":"cardiomegaly","status":"publish","type":"post","link":"https:\/\/glutenfreeworks.com\/health\/cardiomegaly\/","title":{"rendered":"Cardiomegaly"},"content":{"rendered":"<h2><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/Cardiomegaly-Heart-front.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-8864\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/Cardiomegaly-Heart-front.jpg\" alt=\"Cardiomegaly-Heart-front\" width=\"297\" height=\"219\" \/><\/a>What Is Cardiomegaly?<\/h2>\n<p style=\"text-align: justify\"><span class=\"dropcap\">C<\/span>ardiomegaly is\u00a0a non-inflammatory disorder of the myocardium (heart muscle) causing the heart to enlarge.<\/p>\n<p style=\"text-align: justify\"><strong>Q<\/strong>: What happens when the heart enlarges?<\/p>\n<p style=\"text-align: justify\"><strong>A<\/strong>:The heart enlarges because excessive growth of muscle tissue (hypertrophy) thickens the heart walls which in turn\u00a0reduces the size of the lower chambers (ventricles) and impairs the filling of the heart chambers with blood. In consequence, the heartbeat quickens.<\/p>\n<p style=\"text-align: justify\">Also, the enlarging heart encroaches on lung space which impairs their ability to expand with inspiration of air.<\/p>\n<p style=\"text-align: justify\">Cardiomegaly can result in heart failure because of inability to pump sufficient blood for the needs of the body and ventricular arrhythmias (irregular or missed beats) that can stop the heart. An echocardiogram, which is a test that uses sound waves to produce a picture of the heart, is used to detect and diagnose cardiomegaly.<\/p>\n<h2 style=\"text-align: justify\">What Is Cardiomegaly In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p><!--more--><\/p>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\">Cardiomegaly is an associated disorder of celiac disease.\u00a0It is seen as a result of\u00a0serious vitamin B1 (thiamin) deficiency developing as cardiovascular (wet) beriberi characterized by secondary fatty changes, degeneration, and swelling of the muscle fibers.<\/li>\n<li style=\"text-align: justify\">Beriberi is a progressive disease that develops from chronic thiamin deficiency.<\/li>\n<li style=\"text-align: justify\">Hypertension, an associated disorder in celiac disease, is a common cause of cardiomegaly by causing the ventricles (lower chambers) to thicken in order to overcome the increased resistance of arteries to the blood the heart pumps out into them.<\/li>\n<\/ul>\n<h2>How Prevalent Is Cardiomegaly In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p>Cardiomegaly has increased frequency in patients with untreated celiac disease.<\/p>\n<h2>What Are The Symptoms Of Cardiomegaly?<\/h2>\n<p>Cardiomegaly is marked by these symptoms:<\/p>\n<ul class=\"cp_bullet red\">\n<li>Vasodilation (relaxed blood vessels).<\/li>\n<li>Warm extremities.<\/li>\n<li>Tachycardia (rapid heartbeat).<\/li>\n<li>Palpitations.<\/li>\n<li>Lactic acidosis.<\/li>\n<li>Shortness of breath and orthopnea (need to sit up to breath).<\/li>\n<li>Faintness.<\/li>\n<li>Pulmonary and peripheral edema develop with heart failure.<\/li>\n<\/ul>\n<h2>How Does Cardiomegaly In Celiac Disease and\/or Gluten Sensitivity Develop?<\/h2>\n<ul class=\"cp_check red\">\n<li>Cardiomegaly in celiac disease results from malabsorption causing thiamin deficiency.<a href=\"#footnote_1_193\" id=\"identifier_1_193\" class=\"footnote-link footnote-identifier-link\" title=\"Kathleen Mahan and Sylvia Escott-Stump, ed. Krause&rsquo;s Food, Nutrition &amp; Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000.\">1<\/a><\/li>\n<\/ul>\n<h2>Does Cardiomegaly Respond To Gluten-Free Diet?<\/h2>\n<p>Yes. Celiac disease-related cardiomegaly responds to gluten free diet.<\/p>\n<h2>6 Steps To Improve Cardiomegaly Related To Celiac Disease:<\/h2>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>1<\/strong><\/span><\/span><strong><span style=\"color: #800000\">Remove the Trigger. Maintain a Strict, Nutritious Gluten Free Diet:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<b>Treatment<\/b>. This condition responds to the complete elimination of gluten, which is the required treatment that improves both cardiomegaly and gut health.<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.<\/li>\n<li>A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.<\/li>\n<li>Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1\/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Correct Your Individual Nutritional Needs.<\/strong><\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Eat foods that can replenish missing nutrients. Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<li>Take nutritional supplements as needed.\u00a0Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Recovery<\/strong>. You should begin to feel better within a week and notice more energy as inflammation subsides and the \u00a0absorbing cells that make up the surface lining of your small intestine are better able to function.<\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\">Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.<\/li>\n<li style=\"text-align: justify\">Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.<a href=\"#footnote_2_193\" id=\"identifier_2_193\" class=\"footnote-link footnote-identifier-link\" title=\"Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.&nbsp;Clinical Science. Apr 2001;100(4):379-86.\">2<\/a><\/li>\n<li style=\"text-align: justify\">The intestinal lining may take up to a year to heal.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Major Inflammatory Food Types That Reduce Healing<\/strong>:<\/p>\n<ul class=\"cp_bullet red\">\n<li style=\"text-align: justify\"><strong>Damaging Foods<\/strong>. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.<a href=\"#footnote_3_193\" id=\"identifier_3_193\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">3<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Allergenic Foods<\/strong>. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.<\/li>\n<li style=\"text-align: justify\"><strong>Shelf Stable Processed Foods.\u00a0<\/strong>Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_3_193\" id=\"identifier_4_193\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">3<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Fats.<\/strong>\u00a0Limit deep fried foods, trans-fats, saturated fats (animal fat\/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.<a href=\"#footnote_3_193\" id=\"identifier_5_193\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">3<\/a>.<\/li>\n<li style=\"text-align: justify\"><strong>Excessive Refined White Flours\u00a0<\/strong>(bran layer removed)<strong>.\u00a0<\/strong>Includes\u00a0products made from them such as cookies, bread, cakes, pies.\u00a0Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream.\u00a0Also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_3_193\" id=\"identifier_6_193\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">3<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Refined Sugars.\u00a0<\/strong>\u00a0Includes white sugar, corn fructose and high fructose corn syrup.<\/li>\n<li style=\"text-align: justify\"><strong>Certain Spices<\/strong>. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_3_193\" id=\"identifier_7_193\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">3<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Alcohol and Caffeine<\/strong>. Disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_3_193\" id=\"identifier_8_193\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">3<\/a>\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Important Anti-Inflammatory Food Types to Promote Health<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\"><strong>Fruits<\/strong>.\u00a0Contain ample amounts of vitamins, minerals and phytochemicals which are\u00a0naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.<\/li>\n<li style=\"text-align: justify\"><strong>Non-Starchy Vegetables.<\/strong>\u00a0Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes lettuce, kale, onion, broccoli, garlic, and others.<\/li>\n<li style=\"text-align: justify\"><strong>High Quality Complex Carbohydrates<\/strong>. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.<\/li>\n<li style=\"text-align: justify\"><strong>Antioxidants<\/strong>. Protect the body from inflammatory oxidant molecules that continually occur and\u00a0help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as\u00a0nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.<\/li>\n<li style=\"text-align: justify\"><strong>Omega-3 Fatty Acids<\/strong>. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.<\/li>\n<li style=\"text-align: justify\"><strong>Probiotics.\u00a0<\/strong>Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.<\/li>\n<li style=\"text-align: justify\"><strong>Prebiotics\/ High Fiber Foods<\/strong>. \u00a0Food with fiber keeps our population of colonic microbes healthy.<\/li>\n<li style=\"text-align: justify\"><strong>Protective Herbs and Spices<\/strong>. \u00a0See below #6 below for examples.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><strong><span class=\"dropcap\">3<\/span>\u00a0Information Sheet You Can Take to Your Doctor or Other Health Professional:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<p>Click here.<\/p>\n<p>&nbsp;<\/p>\n<ul class=\"cp_check green\">\n<li><span style=\"color: #800000\"><strong><em><span class=\"dropcap\">4<\/span>\u00a0Manage Your Medications\u00a0Safely<\/em>:<\/strong><\/span><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p>Certain prescription drugs can cause nutritional deficiencies that promote cardiomegaly. Ask your doctor or pharmacist about this possible adverse effect.\u00a0<strong>Do not stop medications without supervision.<\/strong><\/p>\n<p><strong>DIURETICS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Loop Diuretics (Lasix\u00ae, Bumex\u00ae, Edecrin\u00ae) deplete Vitamin B1.<\/li>\n<\/ul>\n<p><strong>CARDIOVASCULAR DRUGS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Antihypertensives (Catapres\u00ae, Aldomet) deplete\u00a0Vitamin B1.<\/li>\n<\/ul>\n<p><strong>ANTICONVULSANTS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Phenobarbital and Barbituates; and Dilantin\u00ae, Tegretol\u00ae, Mysoline\u00ae, Depakane\/Depacon\u00ae deplete Vitamin B1.<\/li>\n<\/ul>\n<p><strong>ANTIBIOTICS \u00a0<\/strong>disrupt intestinal permeability.<\/p>\n<ul class=\"cp_bullet blue\">\n<li>Gentomycin\u00ae, Neomycin\u00ae, Streptomycin, Cephalosporins, Penicillins\u00a0deplete\u00a0B Vitamins.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><strong><span class=\"dropcap\">5<\/span>Nutritional Supplements To Help Correct Deficiencies:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p style=\"text-align: justify\">The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.<\/p>\n<ul class=\"cp_bullet orange\">\n<li style=\"text-align: justify\">Multivitamin\/mineral combination once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.<\/li>\n<li style=\"text-align: justify\">100% of the B vitamins to obtain thiamin, or as prescribed by a doctor. About\u00a0B Vitamin Complex supplements: \u00a0some labeling can be confusing, for example, &#8220;B 100&#8221; does not mean 100%. If the ingredient list shows\u00a0\u00a0an excessive amount like\u00a03000% or more, look for another brand because this excessive amount will cause the loss of mineral in the urine.<\/li>\n<\/ul>\n<p><strong>Storage Note<\/strong>:\u00a0<em>Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet &#8211; not in the bathroom or on the kitchen table<\/em>.\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\">\n<li><span style=\"color: #800000\"><em><strong><span class=\"dropcap\">6<\/span>Manage Natural Remedies:\u00a0<\/strong><\/em><\/span><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Hydration<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\">Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.<\/li>\n<li style=\"text-align: justify\">If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.<\/li>\n<li style=\"text-align: justify\">Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.<\/li>\n<li style=\"text-align: justify\">What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Carminatives.\u00a0<\/strong>The following \u00a0anti-inflammatory\u00a0plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort which can come and go.<\/p>\n<p><strong>Carminative Food Remedies<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li>Raspberry.<\/li>\n<li>Carrot is also a cleansing digestive tonic.<\/li>\n<li>Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.<\/li>\n<li>Redbeets also stimulate and improve digestion and are easily digested.<\/li>\n<li>Cabbage also stimulates and improves digestion and is also a liver decongestant.<\/li>\n<li>Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.<\/li>\n<li>Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.<\/li>\n<\/ul>\n<p><strong>Carminative Herb Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li>Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa. \u00a0Drink as tea or use in cooking.<\/li>\n<li>Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.<\/li>\n<li>Parsley also relieves indigestion.<\/li>\n<li>Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion.<\/li>\n<li>Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.<\/li>\n<\/ul>\n<p><strong>Carminative Spice Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li>Cloves are also antispasmodic.<\/li>\n<li>Nutmeg is also useful for indigestion.<\/li>\n<li>Ginger.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Exercise Helps<\/strong>:<\/p>\n<p>Gentle exercise improves circulation and rids the body of toxins but not to aggravate shortness of breath. Even pointing the toes out straight then flexing them back toward you 10 times is a very good help to promote circulation in the legs and prevent clot formation from stagnation when sitting or in bed.<\/p>\n<ul class=\"cp_bullet green\">\n<li>Walking is aerobic exercise that reconditions the whole body to improve stamina.\u00a0Read more about<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">\u00a0Exercise and Fitness<\/a>.<\/li>\n<li>Weight training builds muscle.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<li>Stretching improves flexibilty.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<\/ul>\n<p><strong>Note<\/strong>: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. \n\t\t\t<\/div><\/div>\n<h2>What Do Medical Research Studies Tell About Cardiomegaly In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p><strong>\u201cBeriberi heart disease. A case report describing the haemodynamic features.\u201d<\/strong> This case report describes\u00a0a patient with high-output beriberi.\u00a0Researchers\u00a0studied the hemodynamic changes which took place immediately after intravenous administration of thiamine to the patient. Cardiac output and stroke volume fell rapidly, but not below normal levels, and systemic vascular resistance rose. Beriberi heart disease should be considered in all patients with cardiac failure and a history of dietary deficiency.<a href=\"#footnote_4_193\" id=\"identifier_9_193\" class=\"footnote-link footnote-identifier-link\" title=\"Ayzenberg O, Silber MH, Bortz D. Beriberi heart disease. A case report describing the haemodynamic features. S Afr Med J. 1985 Aug 17;68(4):263-5.\">4<\/a><\/p>\n<ol class=\"footnotes\"><li id=\"footnote_1_193\" class=\"footnote\">Kathleen Mahan and Sylvia Escott-Stump, ed. Krause\u2019s Food, Nutrition &amp; Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_1_193\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_193\" class=\"footnote\">Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.\u00a0<em>Clinical Science<\/em>. Apr 2001;100(4):379-86.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_2_193\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_193\" class=\"footnote\">Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.\u00a0<em>Journal of Gastroenterology and Hepatology<\/em>. 2003;18:479-91.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_3_193\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_4_193\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_5_193\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_6_193\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_7_193\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_8_193\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_193\" class=\"footnote\">Ayzenberg O, Silber MH, Bortz D. Beriberi heart disease. A case report describing the haemodynamic features. <em>S Afr Med J.<\/em> 1985 Aug 17;68(4):263-5.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_9_193\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>What Is Cardiomegaly? Cardiomegaly is\u00a0a non-inflammatory disorder of the myocardium (heart muscle) causing the heart to enlarge. Q: What happens when the heart enlarges? A:The heart enlarges because excessive growth of muscle tissue (hypertrophy) thickens the heart walls which in turn\u00a0reduces the size of the lower chambers (ventricles) and impairs the filling of the heart &#8230;<\/p>\n","protected":false},"author":29,"featured_media":8864,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[4,779,91,1682,54,127],"tags":[101,422,1699,776,1899,319,1701],"class_list":["post-193","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-conditions-2","category-associated-disorder","category-heart","category-malabsorption-disorders","category-cardiovascular","category-thiamin","tag-associated-disorders","tag-cardiomegaly","tag-cardiovascular-system","tag-health-conditions","tag-heart","tag-malabsorption","tag-vitamin-b1-thiamin-deficiency"],"_links":{"self":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/193","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/comments?post=193"}],"version-history":[{"count":15,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/193\/revisions"}],"predecessor-version":[{"id":15497,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/193\/revisions\/15497"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media\/8864"}],"wp:attachment":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media?parent=193"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/categories?post=193"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/tags?post=193"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}