A 62-Year-Old Man With New-Onset Hypertrophic Cardiomyopathy 25 Years After Surgical Remission of Acromegaly

TL;DR

A 62-year-old man developed hypertrophic cardiomyopathy decades after being cured of acromegaly, raising questions about long-term heart risks.

Contribution

This case highlights potential delayed cardiac effects in acromegaly patients even after long-term remission.

Findings

Hypertrophic cardiomyopathy occurred 25 years after acromegaly remission with no other known causes.

Cardiac MRI is recommended for accurate assessment of heart changes in acromegaly patients.

More research is needed to guide screening for cardiac changes in acromegaly survivors.

Abstract

Acromegaly is a rare disease that is caused by a growth hormone (GH) secreting pituitary tumor. This is a case of a 62-year-old man who presented with hypertrophic cardiomyopathy more than 25 years after surgical remission without other known etiologies of left ventricular hypertrophy. The patient initially presented at age 28 with symptoms of acromegaly and diagnosed himself, while several physicians dismissed the diagnosis. He underwent transsphenoidal surgery associated with long-term remission. At age 53, he developed palpitations, light headedness, dizziness, and chest tightness, and an echocardiogram demonstrated left ventricular hypertrophy. At age 60, cardiac magnetic resonance imaging (MRI) suggested hypertrophic cardiomyopathy, which continues to be followed. This case raises the question of whether cardiac morphological changes occur in patients with acromegaly who have GH and insulin-like growth factor-1 (IGF-1) levels well controlled. Cardiac MRI is the most accurate imaging modality for assessment of cardiomyopathy. However, more research is needed to inform clinical guidelines on screening for cardiac functional and morphological changes in patients with acromegaly.

Figures