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Dilated cardiomyopathy with left ventricular thrombi as a presenting feature of Cushing disease

Ji Hye Kim1, So Young Kim2, Ji Hyun Park3

  • 1Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea.

The Canadian Journal of Cardiology
|September 28, 2014
PubMed

Insights

Cushing disease (CD) can cause heart failure and blood clots in young adults. Surgical treatment of CD led to improved heart function and clot resolution, highlighting the link between hormonal imbalance and cardiovascular health.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • Cushing disease (CD) is a rare endocrine disorder caused by excess cortisol.
  • Cardiovascular complications, including cardiomyopathy and thromboembolism, are known risks in CD.
  • The interplay between cortisol excess and cardiac dysfunction requires further elucidation.

Observation:

  • A 20-year-old male patient presented with symptomatic heart failure.
  • Echocardiography revealed dilated cardiomyopathy and two left ventricular apical thrombi.
  • The patient had a confirmed diagnosis of Cushing disease.

Findings:

  • Intracardiac thrombi resolved following intravenous heparin therapy.
  • Symptomatic treatment and subsequent trans-sphenoidal adenomectomy were performed.
  • Cardiac function progressively improved over 3 years post-surgery, suggesting a link between CD management and cardiac recovery.

Implications:

  • This case underscores the importance of recognizing and managing cardiovascular manifestations in Cushing disease.
  • Effective treatment of the underlying endocrine disorder can lead to significant improvement in cardiac function.
  • Further research into the mechanisms of cortisol-induced cardiomyopathy is warranted.

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