Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

07 September 2017 : Case report  Indonesia

Biventricular Cardiac Hypertrophy in a Patient with Primary Aldosteronism and Atrial Septal Defect

Unusual setting of medical care, Rare coexistence of disease or pathology

Tjokorda Gde Dalem Pemayun1ABCDEG, Ridho M. Naibaho2ABCEFG, Muhammad Achmad Sungkar3BCD

DOI: 10.12659/AJCR.902271

Am J Case Rep 2017; 18:963-971

Abstract

BACKGROUND: Primary aldosteronism can be caused by adrenocortical adenoma and is usually associated with left ventricular hypertrophy. Biventricular cardiac hypertrophy and heart failure in the presence of a pre-existing atrial septal defect (ASD) are a rare association of primary aldosteronism.

CASE REPORT: A 33-year-old woman with resistant hypertension and refractory hypokalemia presented with signs and symptoms of heart failure. She had previously been diagnosed having a right adrenal tumor and ostium secundum type ASD. Transthoracic echocardiography confirmed the location of the ASD, with a left-to-right cardiac shunt, moderate to severe tricuspid insufficiency, moderate pulmonary hypertension (60 mm Hg), four chamber dilatation and biventricular hypertrophy. The left ventricular ejection fraction was 17%. Endocrine function tests showed a raised plasma aldosterone concentration (PAC) to plasma renin activity (PRA) ratio, which supported a diagnosis of primary aldosteronism. A captopril suppression test failed to suppress the patient’s PAC, which confirmed the diagnosis. The patient underwent a right adrenalectomy with subsequent normalization of hypokalemia, PAC, and PAC to PRA ratio and her hypertension was managed successfully with monotherapy. Surgical pathology examination of the tumor revealed an adrenocortical adenoma. At follow-up at 18 months, the patient had a normal potassium level, and her cardiac function and ventricular geometries were improved.

CONCLUSIONS: Reversible cardiac hypertrophy is rarely associated with primary aldosteronism, however, it should be recognized. Present findings suggest that aldosteronism contributes to cardiac remodelling and biventricular hypertrophic changes. Administering appropriate treatment in a timely manner, can reverse cardiac changes along with the other symptoms of primary aldosteronism.

Keywords: Adrenalectomy, Hyperaldosteronism, Hypertrophy, Left Ventricular, Hypertrophy, Right Ventricular, Heart Septal Defects, Atrial

Add Comment 0 Comments

In Press

Case report  China

Multiple Succinate Dehydrogenase-Deficient Gastrointestinal Stromal Tumors of the Stomach: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.947545  

Case report  USA

A Diagnostic Dilemma: Disseminated Histoplasmosis Presenting as a Small-Bowel Obstruction

Am J Case Rep In Press; DOI: 10.12659/AJCR.946515  

Case report  China

Single-Incision Laparoscopic Cholecystectomy in Situs Inversus Totalis: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.946523  

Case report  China

Young-Onset Type 2 Diabetes and Its Association with Variant Angina in an Adolescent

Am J Case Rep In Press; DOI: 10.12659/AJCR.947489  

Most Viewed Current Articles

21 Jun 2024 : Case report  China (mainland) 98,085

Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...

DOI :10.12659/AJCR.944371

Am J Case Rep 2024; 25:e944371

0:00

07 Mar 2024 : Case report  USA 52,814

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

20 Nov 2023 : Case report  Saudi Arabia 33,151

Azithromycin Treatment for Acne Vulgaris: A Case Report on the Risk of Clostridioides difficile Infection

DOI :10.12659/AJCR.941424

Am J Case Rep 2023; 24:e941424

0:00

18 Feb 2024 : Case report  Japan 23,669

A Case of Thoracic Empyema Caused by Actinomyces naeslundii

DOI :10.12659/AJCR.943030

Am J Case Rep 2024; 25:e943030

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923