Analysis of 62,000 UK Biobank participants reveals that polygenic risk scores for five major cardiovascular diseases create distinct structural changes in the heart detectable through cardiac MRI. Heart failure risk manifested across all cardiac chambers with left ventricular dysfunction and aortic enlargement, while atrial fibrillation risk primarily caused biatrial enlargement and reduced ejection fractions. Stroke risk showed left ventricular hypertrophy and left atrial dysfunction, coronary artery disease involved mainly left ventricular hypertrophy, and abdominal aortic aneurysm risk enlarged the descending aorta. The research identified 32 cardiac features that mediate between genetic risk and actual disease events. This represents a significant advance in precision cardiovascular medicine, potentially enabling early interventions based on genetic profiles before clinical symptoms emerge. The findings could transform preventive cardiology by identifying high-risk individuals through genetic testing and targeted cardiac imaging. However, this preprint awaits peer review, and results may change. The observational design also cannot establish causation between genetic variants and cardiac remodeling. While promising for risk stratification, clinical implementation requires validation in diverse populations beyond the predominantly European UK Biobank cohort.