What condition is indicated by reduced ejection fraction in a patient with coarse facial features and enlarged fingers?

The condition indicated by reduced ejection fraction in a patient with coarse facial features and enlarged fingers is acromegaly. Acromegaly is caused by excess growth hormone, typically due to a benign tumor of the pituitary gland. This hormonal imbalance leads to characteristic changes in physical appearance, including coarse facial features, enlargement of hands and feet, and other systemic complications.

In patients with acromegaly, the chronic excess of growth hormone can also lead to cardiovascular issues, one of which is a reduced ejection fraction. This can occur as a result of growth hormone's effects on cardiac muscle, potentially leading to cardiomyopathy.

The other conditions present different clinical profiles. Cushing's syndrome is associated with features such as obesity, hypertension, and glucose intolerance rather than specifically coarse facial features or enlarged hands. Hypothyroidism can lead to myxedema and slow heart rates but would not typically present with enlarged fingers and a coarse facial appearance as seen in acromegaly. Paget's disease of bone primarily affects the skeletal system, causing deformities and can lead to a variety of complications, but does not manifest with the same facial features or hand size changes associated with growth hormone excess.