Dilated cardiomyopathy with left ventricular thrombi as a presenting feature of Cushing disease

Abstract

We report on a 20-year-old man with dilated cardiomyopathy and intracardiac thrombi associated with Cushing disease (CD). The patient presented with symptomatic heart failure. Follow-up echocardiography showed 2 thrombi in the apex of the left ventricle, which resolved after intravenous heparin therapy. The patient was first treated symptomatically, and then trans-sphenoidal adenomectomy was performed. Although cortisol excess alone may not be sufficient to produce severe cardiomyopathy, progressive improvement of cardiac function was observed within 3 years after surgery.