Final Answer:
The diagnosis for a patient with reduced ejection fraction, coarse facial features, and enlarged fingers is likely Acromegaly. Diagnostic steps involve checking IGF-1 levels (high) and performing a glucose suppression test. Imaging studies such as MRI can further aid in confirming the diagnosis. The primary treatment for Acromegaly is surgery, and prior to surgery, somatostatin analogs or dopamine agonists may be administered.
Step-by-step explanation:
The clinical presentation of reduced ejection fraction, coarse facial features, and enlarged fingers is suggestive of Acromegaly, a disorder caused by excessive growth hormone (GH) production, often due to a pituitary adenoma. Diagnosis involves assessing Insulin-like Growth Factor-1 (IGF-1) levels, which are typically elevated in Acromegaly. Additionally, a glucose suppression test can be conducted to confirm the inability to suppress GH secretion.
Imaging studies, such as magnetic resonance imaging (MRI), play a crucial role in identifying the pituitary adenoma responsible for GH overproduction. Once diagnosed, the primary treatment for Acromegaly is surgical removal of the adenoma. However, to reduce GH levels and tumor size before surgery, somatostatin analogs (e.g., octreotide) or dopamine agonists (e.g., cabergoline) may be administered. These medications help manage symptoms and improve the likelihood of a successful surgical outcome.
In summary, the approach to Acromegaly involves a stepwise process, including clinical assessment, hormone level measurements, imaging studies for localization, and subsequent surgical intervention. Preoperative medical therapy aims to optimize conditions for surgery and improve overall outcomes. Collaborative efforts between endocrinologists, neurosurgeons, and other healthcare professionals are crucial for the comprehensive management of Acromegaly.