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Published on: August 16, 2021
Acromegalic cardiomyopathy with end-stage heart failure treated with left ventricular assist device: a case report
Liting Guo1, Hui Zheng2, Zhigang Liu3
1Department of Endocrinology, TEDA International Cardiovascular Hospital, Tianjin Medical University, No. 61, Third Avenue, Teda, Tianjin, 300457, China.
Insights
Left ventricular assist device (LVAD) implantation offers a promising treatment for heart failure caused by acromegaly. This case study shows complete symptom relief and stable cardiac condition after LVAD implantation in a patient with severe acromegaly-related heart failure.
Area of Science:
- Cardiology
- Endocrinology
- Medical Case Studies
Background:
- Acromegaly-related heart failure is a rare condition with challenging diagnosis and suboptimal treatment outcomes.
- Standard treatments include managing heart failure symptoms and reducing growth hormone (GH) levels.
- Left ventricular assist device (LVAD) presents a potential therapeutic avenue for these patients.
Purpose of the Study:
- To present a case study of a patient with severe acromegaly-related heart failure.
- To evaluate the efficacy of LVAD implantation in managing this condition.
Main Methods:
- A 54-year-old female with New York Heart Association class IV heart failure was treated.
- Acromegaly was diagnosed via clinical features, elevated GH, and pituitary macroadenoma.
- Bromocriptine was administered for GH reduction, followed by LVAD implantation.
Main Results:
- The patient experienced complete relief of cardiac symptoms within one week post-LVAD surgery.
- Cardiac condition remained stable during one year of follow-up.
- Growth hormone levels gradually decreased post-treatment.
Conclusions:
- LVAD implantation can be an effective treatment for patients suffering from acromegaly-related heart failure.
- This approach led to significant clinical improvement and stable outcomes in the presented case.
Background:
Acromegaly-related heart failure, as a rare cause of heart failure, presents a substantial healthcare challenge owing to their insidious onset and overlapping symptoms. Current management often includes systemic anti-heart failure treatment and reducing growth hormone(GH) levels, yet cardiac outcomes remain unideal. Left ventricular assist device(LVAD) may be a valuable therapeutic option in such patients.
Case Presentation:
We report a case of a 54-year-old Chinese female diagnosed with severe congestive heart failure, classified as New York Heart Association class IV. The clinical symptom failed to improve, despite systemic anti-heart failure treatment. Heart failure arising from acromegaly was suspected due to her facial features, and confirmed through elevated levels of GH and a pituitary macroadenoma demonstrated by magnetic resonance imaging. Upon diagnosis of acromegaly, bromocriptine was initiated to reduce GH levels. Subsequently, our multidisciplinary team administered LVAD implantation, resulted in cardiac symptoms completely relieved within one week postoperatively. During one-year follow-up, the patient's heart condition remained stable and the GH gradually decreased.
Conclusion:
LVAD may be a valuable therapeutic option in acromegaly-related heart failure patients.
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