Abstract
An 18-year-old female patient diagnosed with McCune–Albright syndrome (MAS) developed postoperative acute heart failure with negative findings during preoperative cardiac screening and restricted fluid infusion. Latent cardiovascular involvement of MAS could be a reasonable explanation for the present case.
INTROUCTION
McCune-Albright syndrome (MAS) is a rare genetic disease characterized by polyostotic fibrous dysplasia, skin hyperpigmentation, and endocrine dysfunction, with the prevalence ranging between 1/100 000 and 1/1 000 0001, 2. Due to the severe deformity of lower limbs caused by fibrous dysplasia in the proximal femur or tibia, substantial numbers of patients diagnosed with MAS are admitted to orthopedics clinics for surgical interventions3. Although the skeletal and endocrine abnormalities of MAS are well recognized by most clinicians, rare but fatal cardiovascular involvement is seldom reported. It is also reported that cardiac abnormality such as myocyte hypertrophy, visible microscopically in a macroscopically normal heart, strongly suggests that Gs mutation may be present in the heart with inconspicuous macroscopic findings4. Thus, the cardiovascular involvement of MAS patients is prone to be overlooked in clinical practice and related to potential risk of medical disputes. To the best of our knowledge, cardiovascular involvement of MAS patients who underwent orthopedic surgery has not yet been presented. Here, we report the case of a young woman with MAS who suffered from acute heart failure after proximal femur osteotomy for lower limb deformity correction, although she had no positive cardiovascular abnormality or  history of cardiovascular disease.
CASE PRESENTATION