an enlarged heart should leave some kind of evidence on a simple ekg, and can be confirmed on an echo. Not true. For something so potentially serious it's something that's often very easily missed even with an EKG. i have an enlarged heart, and i had a funky rythm that was picked up on an ekg. my doctor knew what to look for, so, i guess it may have to do with the physician or with my individual situation, but if doctors are looking for these types of things, they'll probably find them more times than not--even without super-expensive prcedures. Again, not necessarily, and like you said it had more to do wth your particular situation. Even if a doctor is looking for something specific with an EKG it can still easily go undetected. Enlarged hearts are relatively very common and go missed all the time. I'm not arguing against people being able to be tested along these lines; just that it's far from a surefire bet to be caught.