Clinical case of using epleronon and candesartan for correction of heart failure in patients with Ebshtein’s anomaly

Abstract

Aim. To evaluate the efficacy of eplerenone and candesartan in heart failure correction in a patient with Ebstein's anomaly detected in adulthood. Methods. A clinical case of long-term follow-up of a patient with a rare pathology, Ebstein's anomaly detected in adulthood, is described. The data of subjective examination are given. The anomaly was identified during a screening heart ultrasound exam, the patient had no complaints before, and had no history of chronic diseases, including congenital heart defects among family members. Also, the patient underwent routine diagnostic methods general clinical studies, cardiac echocardiography, magnetic resonance imaging of the heart, N-terminal pro-brain natriuretic peptide measurement. In addition, the effect of correcting the signs of heart failure with a combination of candesartan and eplerenone in the complex treatment of heart failure according to echocardiography data and the level of N-terminal pro-brain natriuretic peptide is shown. Results. A decrease in the level of N-terminal pro-brain natriuretic peptide, an increase of the ejection fraction according to echocardiography with the use of eplerenone and candesartan in the complex treatment of heart failure in these patients were demonstrated. Conclusion. Despite the limited data on the use of antagonists of mineralcorticoid receptors and angiotensin receptor blockers among the patients with Ebstein's anomaly, the clinical case presented in the article demonstrates high effectiveness of this combination in treating heart failure in such patients.