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Acromegalic Cardiomyopathy With Malignant Arrhythmogenic Pattern Successfully Treated With Mechanical Circulatory

Sara Doimo1, Daniela Miani2, Nicoletta Finato3

  • 1Cardiovascular Department "Ospedali Riuniti" of Trieste and Post Graduated School of Cardiovascular Sciences, University of Trieste, Trieste, Italy.

The Canadian Journal of Cardiology
|May 2, 2017
PubMed

Insights

Acromegalic cardiomyopathy, a heart condition from excess growth hormone, can worsen even after pituitary tumor removal. This case highlights severe heart failure and arrhythmias requiring advanced life support and heart transplant.

Area of Science:

  • Cardiology
  • Endocrinology
  • Cardiovascular Medicine

Background:

  • Acromegaly frequently causes cardiovascular complications, including acromegalic cardiomyopathy.
  • This condition involves heart muscle thickening and impaired function, leading to heart failure and arrhythmias.
  • These cardiac issues are associated with a poor prognosis in acromegaly patients.

Observation:

  • A 48-year-old man with acromegalic cardiomyopathy due to a pituitary adenoma was studied.
  • Following successful tumor resection, the patient experienced severe ventricular arrhythmias (arrhythmic storms).
  • These events progressed to cardiogenic shock, necessitating intensive mechanical circulatory support.

Findings:

  • Despite successful pituitary tumor treatment, the patient's acromegalic cardiomyopathy led to life-threatening complications.
  • Mechanical support, including intra-aortic balloon pump and ECMO, was required for cardiogenic shock.
  • Urgent heart transplantation became necessary due to the refractory cardiac failure.

Implications:

  • This case underscores the potential for severe, progressive cardiac dysfunction in acromegaly, even post-tumor treatment.
  • It highlights the critical need for vigilant cardiac monitoring in acromegaly patients.
  • Advanced interventions and heart transplantation may be required for end-stage acromegalic cardiomyopathy.

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