Will an enlarged heart return back to normal without medication?

Not usually: Once the process starts, an ongoing phenomenon called "remodeling" tends to keep things going in the wrong direction. Good medical therapy can often (but not always) halt or sometimes even reverse this process.

Uncertain.: If the heart enlargement occurred because of a high amount of salt with resultant hypertension, then salt restriction could reduce ones BP and reverse the heart enlargement. However, first, one must determine the underlying cause of the heart enlargement; it could be hypertension, a valve problem, or a primary heart muscle abnormality. Treatment of these problems can reverse the heart size.