An enlarged bi-atrial heart does not necessarily indicate heart failure. Heart failure is an end-stage manifestation of heart disease, and an enlarged atrium is one of the manifestations of heart failure, but it doesn’t mean that as long as it is enlarged, it is heart failure. Rheumatic heart disease, congenital heart disease or coronary heart disease, dilated cardiomyopathy, etc. can cause bi-atrial enlargement of the heart, at this time the heart may still be in the compensatory period, the heart function can still maintain basically normal. With the deterioration of the condition, the contractility of the heart is weakened, or the burden on the heart is increased, when the heart function gradually declines to the point that it loses the ability to compensate, that is, it enters the heart failure stage. If a patient has enlarged both chambers of the heart, it is recommended that the patient consult a doctor in time to determine the cause of the enlargement and the severity of the condition, and choose the appropriate treatment plan under the guidance of the doctor according to the specific condition.