SUN-098 A Hidden Deficiency, A Broken Heart: Severe Coronary Artery Disease In Untreated Growth Hormone Deficiency

Abstract Disclosure: S. Abdulkadir: None. S. Avula: None. Introduction: Growth hormone deficiency (GHD) in adulthood can cause dyslipidemia, increased total body fat with a greater proportion in the visceral compartment, as well as endothelial dysfunction. Additionally, impaired fibrinolysis due to a decrease in tissue plasminogen activator has also been reported in some studies. Collectively, these metabolic and vascular abnormalities contribute to an increased risk of cardiovascular events in adults with GHD. Case Description: A 39-year-old male with a history of congenital GHD, hypothyroidism, and type 2 diabetes mellitus presented following a pulseless electrical activity (PEA) arrest, with return of spontaneous circulation (ROSC) achieved in the field. He had not been on any prescribed medications for at least six years prior to presentation. Initial vital signs were unremarkable. Laboratory studies revealed high-sensitivity troponin of 7 ng/L (reference range: <35 ng/L) with an elevation to 116 on two hour recheck. Patient did not have anginal chest pain or respiratory symptoms. Electrocardiogram showed mild ST depressions in the inferior and precordial leads. Given the mild troponin elevation and absence of cardiac symptoms, the ECG findings were attributed to myocardial injury related to cardiopulmonary resuscitation (CPR). The patient was admitted and underwent coronary angiography on hospital day 2, which revealed severe multivessel coronary artery disease not amenable to percutaneous intervention. A decision was made to proceed with coronary artery bypass grafting (CABG), and on hospital day 10, the patient successfully underwent six-vessel CABG without complication. Discussion and Conclusion: This patient with untreated adult GHD presented with multiple metabolic and cardiovascular risk factors, including central obesity, dyslipidemia, insulin resistance, and ultimately, severe multivessel coronary artery disease. While the association between GHD and increased cardiovascular risk is well documented in the literature, there is a lack of consensus on whether growth hormone replacement therapy should be continued or initiated in adulthood for its potential cardioprotective benefits. This case highlights the need for further investigation into the long-term cardiovascular outcomes of adult patients with GHD and whether growth hormone therapy could modify these risks. It also underscores the importance of aggressive cardiovascular risk assessment and management in this population. Presentation: Sunday, July 13, 2025