Plummer-Vinson Syndrome and Heart Failure: An Unusual Association in an African American Woman.

Abstract

Patient: Female, 48Final Diagnosis: Plummer-Vinson syndromeSymptoms: Chest pain • fatigue • palpitationMedication: —Clinical Procedure: Esophagogastroduodenoscopy (EGD) • colonoscopySpecialty: General and Internal MedicineObjective:Rare diseaseBackground:Plummer-Vinson syndrome (PVS) is a rare disorder composed of the triad of dysphagia, iron-deficiency anemia (IDA), and esophageal webs. It is most prevalent in middle-aged white women, and the dysphagia often improves when the anemia is treated. It is well established that chronic hypertension can lead to congestive heart failure (CHF). While IDA is frequently found concomitantly with CHF, there have been no reported cases of new-onset CHF with anemia presenting as PVS.Case Report:We present the case of a 48-year-old African American woman with symptomatic anemia and new-onset congestive heart failure secondary to hypertension, who presented with the classic symptoms of PVS.Conclusions:CHF with accompanying IDA may be an independent risk factor for the development of PVS. At the very least, there is an association between CHF-induced IDA and PVS. Patients presenting with CHF with symptoms of dysphagia should be considered at risk for the syndrome, and endoscopy may be warranted. Treatment for PVS includes iron replacement, and in some cases requires mechanical dilation.