Abstract
Obesity is a prevalent and under-recognized contributor to heart failure with preserved ejection fraction. We present a unique case of a patient with severe, diuretic-refractory obesity-related heart failure with preserved ejection fraction and cognitive delay who experienced complete resolution of heart failure symptoms following endoscopic gastric balloon placement. This intervention, combined with supervised group living and glucagon-like peptide-1 (GLP-1) therapy, resulted in a 48.9% total body weight loss and discontinuation of oxygen and loop diuretics. This case underscores the therapeutic potential of endobariatric procedures in patients with significant weight-related comorbidities who are nonsurgical candidates.