Reversal of Severe Biventricular Dysfunction From Cardiac Hemochromatosis With Iron Removal

A 47-year-old man presented with 1-week history of cough and bilateral lower extremity swelling. He had a 5-year history of diabetes mellitus and hypogonadism. His ECG demonstrated sinus rhythm with low-limb voltage and left anterior hemiblock. An echocardiogram showed severely reduced left ventricular ejection fraction 10%, restrictive diastolic filling, and severe right ventricular dysfunction (Figure 1, Movie I–IV in the online-only Data Supplement). Laboratory testing revealed brain natriuretic peptide 1849 pg/mL, ferritin 6389 µg/L, iron 108 µg/dL, transferrin 124 mg/dL, total iron binding capacity 171 µg/dL, and transferrin saturation 63%. Figure 1. Echocardiogram showed early:atrial mitral inflow velocity ratio (E/A) >2, short deceleration time (DT) …