Treatment. Treatment for an enlarged heart will depend on the cause. Medication is usually the first step for heart conditions. Different medications work for different conditions. Diuretics are a common choice. They reduce sodium and excess water levels in the body. Some medications work on dealing with high blood pressure. These include ACE inhibitors, angiotensin receptor blockers and beta blockers. Trying those medications should improve the ability for the heart to pump and get rid of the need of it to get so large. Anticoagulants are also a common choice. They work to stop blood clots from forming. People with an enlarged heart may find them at risk of a heart attack or stroke. Blood clots are the main cause of these issues.