Anaesthetic Management of a Patient with Acromegaly and Dilated Cardiomyopathy: A Case Report

Acromegaly is a rare endocrine disorder primarily caused by excessive Growth Hormone (GH) secretion, often due to an anterior pituitary macroadenoma. Patients frequently experience cardiovascular complications, including hypertension and Dilated Cardiomyopathy (DCM). A 32-year-old male presented with features suggestive of acromegaly, including headache and blurred vision. Hormonal tests revealed a growth hormone level of 21 ng/mL and an Insulin-like Growth Factor-1 (IGF-1) level of 778.7 ng/mL. Magnetic Resonance Imaging (MRI) identified a 2.4×2.8×3.1 cm GH-secreting pituitary macroadenoma. Two-dimensional echocardiography indicated severe DCM with a Left Ventricular Ejection Fraction (LVEF) of 15-20% and severe diastolic dysfunction. The patient had no prior history of diabetes or hypertension and underwent successful endonasal trans-sphenoidal excision of the tumour, despite challenges posed by impaired cardiac function. This case emphasises the importance of careful anaesthetic management in acromegaly patients with cardiomyopathy