Acromegaly presenting as cardiac failure

Area of Science:

• Cardiology
• Endocrinology
• Medical Case Reports

Background:

• Acromegaly, a rare disorder, is associated with cardiac structural and functional changes, contributing to increased mortality.
• Clinically evident heart failure is an uncommon manifestation of acromegaly, particularly in Nigeria.
• This report focuses on a late presentation of acromegaly manifesting as severe heart failure.

Observation:

• A 45-year-old woman presented with a 4-year history of acromegaly symptoms and a 6-week history of worsening heart failure.
• Physical examination revealed characteristic acromegalic features, galactorrhoea, and signs of congestive cardiac failure.
• Radiological findings included gross cardiomegaly and pituitary fossa destruction; hormonal assays confirmed hyperprolactinemia and elevated growth hormone levels.

Findings:

• Echocardiography demonstrated left ventricular hypertrophy, dilation, and both diastolic and systolic dysfunction.
• The patient was diagnosed with acromegalic cardiomyopathy and severe congestive heart failure.
• Management involved anti-heart failure medications and a dopamine agonist, with initial positive response.

Implications:

• This case underscores the importance of recognizing acromegaly as a cause of heart failure, even in resource-limited settings.
• Late presentation and complex comorbidities pose significant management challenges.
• Increased awareness and early detection are vital for improving outcomes in acromegaly patients with cardiac involvement.