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Pulmonary hypertension is high blood pressure within the artery that connects the lungs and heart. It forces the heart to work harder to transfer blood between the heart and lungs, which may lead to an enlargement of the right side. Thyroid problems, whether they involve an underactive or overactive thyroid, can cause a heart to enlarge.
Other medical conditions are less frequent causes of left atrial enlargement. For example, a ventricular septal defect -- a hole in the wall that separates the right and left ventricles -- can alter blood flow through the heart such that there is overfilling and enlargement of the left atrium.