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Aortic root dilation in acromegaly
  1. Yvette Ayewa Yeboah-Kordieh1,
  2. Waqar Arif2,
  3. David Weisman1 and
  4. Roberto Salvatori3
  1. 1Internal Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland, USA
  2. 2Department of Pathology, Johns Hopkins Medicine, Baltimore, Maryland, USA
  3. 3Johns Hopkins Pituitary Center, Johns Hopkins Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Yvette Ayewa Yeboah-Kordieh; yvetteeliza93{at}gmail.com

Abstract

Previous studies have linked persistent elevations in growth hormone (GH) and insulin-like growth factor-1 (IGF-1) to cardiac abnormalities including aortic root dilation. Guidelines in the management of this dilation below the size recommended for surgery have not been well defined but follow-up and intervention when appropriate could be life-saving. We report the case of a man in his 60s who had been living with undiagnosed acromegaly for many years. His initial assessment through point-of-care ultrasound raised concerns about potential cardiac enlargement, prompting further investigation with a formal echocardiogram, which revealed a significant aortic root dilation measuring 4.5 cm. Subsequent blood tests confirmed elevated levels of IGF-1. Brain MRI showed a focal lesion in the pituitary gland, which was surgically resected, confirming the diagnosis of a GH-secreting pituitary adenoma. One year after surgery, a repeat CT angiogram of the chest demonstrated a stable size of the aortic root aneurysm.

  • pituitary disorders
  • general practice / family medicine
  • arteries

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: YAY-K, WA, DW and RS. The following authors gave final approval of the manuscript: YAY-K, WA, DW and RS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.