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Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice
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Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice

Published on: February 10, 2013

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Acromegaly-induced cardiomyopathy with dobutamine-induced outflow tract obstruction

Mahmoud A Abdelsalam1, Todd B Nippoldt2, Jeffrey B Geske1

  • 1Department of Cardiology, Mayo Clinic, Rochester, Minnesota, USA.

BMJ Case Reports
|March 11, 2016
PubMed

Insights

Acromegaly can cause cardiomyopathy that mimics hypertrophic cardiomyopathy during dobutamine stress tests. Early diagnosis and management of this condition are vital for improving survival in acromegaly patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Cardiovascular Imaging

Background:

  • Acromegaly, a condition caused by excess growth hormone, can lead to significant cardiovascular complications, including cardiomyopathy.
  • Preoperative cardiac evaluation is crucial for patients with acromegaly undergoing pituitary surgery.

Observation:

  • A 50-year-old man with acromegaly presented for preoperative cardiac assessment.
  • Dobutamine stress echocardiography revealed a hyperdynamic left ventricular ejection fraction (LVEF) and a significant left ventricular outflow tract (LVOT) gradient, but no myocardial ischemia.
  • Cardiac MRI showed concentric hypertrophy without delayed enhancement.

Findings:

  • Acromegaly-induced cardiomyopathy can present with features mimicking hypertrophic cardiomyopathy, particularly under dobutamine provocation.
  • The observed LVOT gradient during stress testing is a key diagnostic clue.

Implications:

  • This case highlights the importance of recognizing acromegaly-induced cardiomyopathy to avoid misdiagnosis as primary hypertrophic cardiomyopathy.
  • Prompt diagnosis and tailored management of acromegaly-related cardiac dysfunction are essential for improving patient outcomes and survival.

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