Acromegaly is a rare medical condition that causes bones, organs, and other tissues throughout the body to become larger than usual. It happens when your pituitary gland makes too much growth hormone (GH). The National Institute of Diabetes and Digestive and Kidney Diseases estimates that 3 to 14 out of 100,000 people have acromegaly.

Complications from acromegaly include type 2 diabetes, arthritis, and conditions that affect your muscles, cartilage, and bones. Acromegaly can also be a factor in developing heart disease and heart failure.

Acromegaly is associated with a lower life expectancy and higher mortality rate. But your outlook can be more encouraging if doctors diagnose and treat it early. Because acromegaly can lead to heart failure, it’s important to check with a doctor or healthcare professional as soon as symptoms develop.

In acromegaly, the excess GH you produce leads to left ventricular hypertrophy (LVH). With LVH, your heart muscle becomes larger and thicker. This can also cause your blood pressure to increase.

Acromegaly also appears to contribute to heart valve disorders. You may develop aortic or mitral valve regurgitation.

Regurgitation means the valves don’t close properly between heartbeats, allowing blood to flow backward. Among the complications are high blood pressure and abnormal heart rhythms, such as atrial fibrillation.

Of all the serious health complications associated with acromegaly, cardiovascular disease is the most serious. According to a 2018 study, cardiovascular disease is responsible for more than half of acromegaly-related deaths. That research also suggests that end stage congestive heart failure resulting from an enlarged heart usually occurs in older adults who haven’t been able to manage the disease or those who have other cardiovascular problems.

LVH affects your heart’s left ventricle, the chamber that pumps blood out to most of the body. When this happens, your heart isn’t as effective at pumping blood to meet your body’s needs. This causes your blood pressure to increase.

High blood pressure from acromegaly causes systolic dysfunction, which means your heart pumps less blood with each contraction. This causes your heart to work harder. That burden can lead to heart failure.

Acromegaly can also cause other complications that contribute to heart failure, such as obstructive sleep apnea (OSA). Acromegaly can cause the bones in your jaw and front of your skull to become enlarged and your tongue and other soft tissues in the larynx to become thicker. These changes can cause your airway to become blocked.

OSA can cause repeated pauses in breathing during the night. These pauses also cause your heart to work harder, further contributing to a weaker heart muscle and heart failure.

Acromegaly may also contribute to type 2 diabetes by triggering insulin resistance. That’s when your organs don’t respond to insulin and can’t effectively use glucose for energy. Too much glucose in your blood can damage your blood vessels, making them blocked and less efficient. This causes your heart to pump harder to send blood throughout the body.

Screening for acromegaly usually follows noticeable changes in the body, such as:

  • the brow and jaw changing shape, becoming more pronounced
  • hands and feet becoming swollen
  • skin becoming thicker, sometimes oilier

If a doctor suspects acromegaly, they may order two different blood tests to determine if your body is producing too much GH. The two screenings are:

  • Insulin-like growth factor (IGF) test: IGF-1 is a hormone involved in regulating GH in your body. Unlike GH levels, which can change throughout the day, IGF-1 levels tend to remain steady. Higher-than-normal IGF-1 levels suggest you may have acromegaly.
  • Oral glucose tolerance test (OGTT): In an OGTT, you swallow a sugary liquid before a medical professional draws your blood. They’ll test your blood every 30 minutes for up to 2 hours to check your GH levels. The sugary liquid normally causes GH levels to dip, but if they remain high, you likely have acromegaly.

Diagnosing heart disease that may be related to acromegaly also involves blood tests checking for:

Other screenings to look for changes to the anatomy of the heart or problems with heart function include:

A doctor should also listen to your heart with a stethoscope and check your blood pressure. If any of these screenings or specific symptoms warrant further evaluation, more invasive tests, such as cardiac catheterization, may be appropriate.

The best treatment depends on several factors, especially the type and severity of the illness. In some cases, treating the underlying acromegaly can help relieve heart disease symptoms.

A 2017 study of cardiovascular disease in people with acromegaly suggests that using somatostatin analogs for 6 to 24 months may decrease LVH and improve heart function.

Because acromegaly is often due to a tumor in the pituitary gland, surgery to remove the tumor or radiation treatment to shrink the tumor can also halt the progression of symptoms and complications. A 2016 study of surgical acromegaly outcomes reported an overall remission rate greater than 75%.

Medications and lifestyle changes are usually necessary to treat heart-related problems associated with acromegaly. You may also need devices or procedures to restore optimal heart function. If you have valve disease, repair or replacement of the affected valve is often a safe and effective solution.

Doctors may treat arrhythmias with antiarrhythmic drugs or procedures, such as cardioversion or ablation. A doctor may also prescribe blood thinners if they determine the arrhythmia is a stroke risk.

And if you develop heart failure, a doctor may prescribe the following types of medications:

Doctors also treat heart failure with certain devices. An implantable cardioverter defibrillator can help keep a healthy heart rhythm. A left ventricular assist device can act as an artificial pump to increase blood flow out of the heart.

People with acromegaly usually only develop heart failure if their condition goes untreated or is poorly treated for a long time. In such cases, the 5-year mortality rate is about 37.5%.

But if doctors diagnose and treat heart failure in its early stages, along with acromegaly, your outlook is much better.

It’s not always possible to prevent acromegaly from leading to heart failure or other cardiovascular complications. But the best way to lower the risk of complications is to respond to acromegaly symptoms early, work closely with your doctors to treat the condition, and monitor your heart health for any signs of trouble.

Does acromegaly always lead to heart failure?

Acromegaly often causes multiple medical complications, but heart failure and other heart-related problems aren’t always among them. However, when doctors make an initial diagnosis, it’s not possible to predict all the health problems that may ensue.

Is acromegaly life threatening?

Acromegaly can be a life threatening condition. But people who receive an early diagnosis can often start a treatment regimen that reduces symptoms and severe complications.

Does recovery from acromegaly reverse damage to the heart?

Successful treatment of acromegaly may halt damage to the heart. But usually, you can’t reverse damage to your heart muscle and valves without surgery or other procedures. Recovery from acromegaly lowers the risk that further damage is likely to occur.

Acromegaly is an uncommon condition in which your body produces too much growth hormone. Because it leads to excessive tissue growth, most organs, including the heart, are at risk of complications.

Cardiovascular complications tend to be the most common. They include:

  • high blood pressure
  • cardiomyopathy
  • valve disease
  • arrhythmias

All of the above can contribute to the development of heart failure.

But a prompt diagnosis and adherence to medications and other treatments can lower your risk of acromegaly leading to long-term heart problems.