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.
摘要:
先前的研究已将生长激素(GH)和胰岛素样生长因子-1(IGF-1)的持续升高与心脏异常(包括主动脉根部扩张)联系起来。在手术推荐的大小以下的这种扩张的管理指南尚未得到很好的定义,但在适当的时候进行随访和干预可以挽救生命。我们报告了一个60多岁的男子的病例,他多年来一直患有未确诊的肢端肥大症。他通过即时超声进行的初步评估引起了人们对潜在心脏扩大的担忧,用正式的超声心动图提示进一步调查,显示明显的主动脉根部扩张,测量4.5厘米。随后的血液测试证实IGF-1水平升高。脑部MRI显示脑垂体有局灶性病变,手术切除了,确认诊断为分泌GH的垂体腺瘤。手术一年后,胸部重复CT血管造影显示主动脉根部动脉瘤大小稳定。