An Unusual Etiology of Severe Right Heart Failure Deserving of Wider Recognition (JACC Case Reports March 2024)-Article: An Unusual Etiology of Severe Right Heart Failure Deserving of Wider Recognition

Article: An Unusual Etiology of Severe Right Heart Failure Deserving of Wider Recognition

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The case report details the presentation of a 31-year-old man with severe right-sided heart failure attributed to scurvy, a condition caused by vitamin C deficiency. The patient, previously healthy, experienced symptoms including shortness of breath, petechial rash, and malaise. Initial work-up revealed anemia, elevated indirect bilirubin, and signs of right heart failure. Differential diagnoses considered included pulmonary hypertension and thrombotic disorders. Further investigations confirmed scurvy, and supplementation with vitamin C led to a rapid resolution of symptoms. The patient's lifestyle habits, including poor dietary choices, were identified as contributing factors to the deficiency. The discussion highlighted the mechanisms through which vitamin C deficiency can lead to pulmonary hypertension and right heart failure, emphasizing the importance of recognizing and addressing nutritional deficiencies in such cases. The report underscores the need for clinicians to be aware of the possibility of vitamin C deficiency in patients presenting with heart failure and pulmonary hypertension, particularly in populations at risk of micronutrient deficiencies due to socioeconomic factors. Successful management included vitamin C supplementation, diuretic therapy, and lifestyle modifications, with a significant improvement observed within a week after treatment initiation. This case serves as a reminder of the critical role of nutritional assessment and intervention in patients with unusual etiologies of heart failure.

Keywords

case report

31-year-old man

severe right-sided heart failure

scurvy

vitamin C deficiency

shortness of breath

petechial rash

anemia

pulmonary hypertension

nutritional deficiencies