Abstract
A woman in her 70s was admitted with progressive dyspnea on exertion. She had abnormal levels of serum ferritin and was diagnosed with sideroblastic anemia with hepatic hemochromatosis based on chemical study and liver biopsy 2 years previously. She showed marked elevation of serum ferritin levels (3,210 ng/ml), cardiomegaly on chest X-p, conduction disturbance on electrocardiography, and high intensity of the left and right ventricular walls on plain chest CT indicating myocardial iron deposition. Echocardiography on admission revealed diffuse left ventricular hypokinesis (ejection fraction 35%) without left ventricular dilatation (left ventricular end-diastolic dimension 53 mm). In spite of intensive treatment, her biventricular heart failure progressed, and a second echocardiography showed depressed systolic mitral annular excursion, right ventricular dilatation and systolic dysfunction, granular high-intensity echo-speckles in the interventricular septum, and restrictive pattern of the transmitral Doppler indices. These echocardiographic findings correspond to cardiac hemochromatosis. Here we report this case of cardiac hemochromatosis diagnosed by echocardiography.
