Generally speaking, if the left ventricle is mildly enlarged and there is no corresponding clinical manifestation of heart failure, it can be temporarily observed first, for example, if the left ventricle is mildly enlarged due to hypertension, clinicians still mainly focus on controlling hypertension, treating the original disease and reviewing it regularly. If the left ventricle is significantly enlarged and heart failure manifests, the clinician should take further targeted treatment, including drugs and special devices, such as CRT, i.e., three-chamber pacemaker. Since the ventricular motion tends to be uncoordinated after ventricular enlargement, patients may need CRT implantation to maintain coordinated ventricular motion. At the same time, the implantation of CRT can help improve the patient’s cardiac function, and in some patients, the enlarged heart can even shrink after the implantation of CRT. Of course, drug therapy is the most basic, regardless of the cause of heart enlargement, after reaching the stage of heart failure must be strictly in accordance with heart failure treatment, such as angiotensin-converting enzyme inhibitors, beta-blockers, and even the addition of spironolactone, which is an aldosterone receptor antagonist, to prevent the patient’s heart from further enlargement, while reducing the damage to heart function, so that heart function is maintained at this level as much as possible. It is possible that the heart may shrink in some patients with good clinical results after treatment, but as long as the clinician can stop the heart from expanding further, the treatment goal is achieved.