Hi wlassalle,
About 3 years ago I was admitted as an emergency patient with pulmonary edema (I inhaled much dust while working on a home project and that may have triggered the edema!?). Tests indicated I had had a heart attack sometime prior without my knowledge (no symptoms until congestion). I had/have a completely blocked LAD and the RCA artery was stented.
The left ventricle was enlarged (dilated cardiomyopathy), and there was severe mitral valve regurgitation.
Apparently, the cause for the LV enlargement was due (the inhalation of dust aside) to the heart compensating to help overcome the high resistance of vessels, the lower than normal cardiac output due to the regurgitation, and some heart wall impairment at the distal end of the heart.
Medication has lowered the heart workload by dilating vessels, reducing heart rate, reducing body fluids, and increase heart contractions. With time the recent echo shows my heart to be normal in size, pumping efficiency is normal, and my mitral valve regurgitation is moderate. The wall motion impairment does not appear to be an issue.
I am fortunate as I tolerate medication well, and there isn't any noticable side effects. Exercise, eat properly, etc. also is a factor.