Small heart..big heart

We usually say : he is kind, he has a big heart. But, no one says: he has small heart. why?

On cardiology &Internal medicine rounds: We ask the medical students to :

* Enumerate causes of large heart shadow on X Ray.

*Tell me causes of cardiomegaly.

Rarely to ask them the reverse:

*Enumerate causes of small heart shadow on X Ray.
*Tell me causes of small cardiac dimensions.

I asked one of the residents few days ago that question. Tomorrow, I will discuss that topic with them.

Here is the answer.

• Neoplastic Disorders
• Allergic, Collagen, Auto-Immune Disorders.
• Deficiency Disorders :Dehydration Cachexia status (inanition) usage.
• Degenerative, Necrosis, Age Related Disorders (Presbycardia )
• Psychiatric Disorders (Anorexia nervosa).
• Anatomic, Foreign Body, Structural Disorders ( Pericarditis, chronic constrictive)
• Vegetative, Autonomic, Endocrine Disorders
  Addison's disease (chronic adrenal insufficiency )
• Emphysema/COPD/Chronic lung disease
• Severe Hypothroidism
• Instrument errors.