Maryam Heidarpour, Mohammad Mehdi Zare, Shiva Armani, Hedie Torkashvan, Sadegh Mazaheri-Tehrani, Davood Shafie
{"title":"急性心力衰竭是原发性肾上腺功能不全的首发症状:如不及时诊断,死亡率极高!","authors":"Maryam Heidarpour, Mohammad Mehdi Zare, Shiva Armani, Hedie Torkashvan, Sadegh Mazaheri-Tehrani, Davood Shafie","doi":"10.1155/2024/5759629","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Primary adrenal insufficiency is an uncommon condition that manifests as nonspecific symptoms such as fatigue, weight loss, salt craving, and hyperpigmentation. Common cardiovascular presentations of AI are hypotension, arrhythmias, and syncope. However, acute heart failure is an uncommon presentation. <i>Case Presentation</i>. Here, a 26-year-old man was hospitalized with vasopressor-resistant cardiogenic shock, which was finally attributed to an adrenal crisis. His past medical history was notable for Hashimoto's disease, controlled with oral levothyroxine.</p><p><strong>Conclusion: </strong>AI should be considered among patients with cardiogenic shock who are unresponsive to conventional inotropes. Additionally, a history of autoimmune diseases may increase the suspicion of AI. Although the presentation of cardiogenic shock in a patient with undiagnosed AI is considered a rarity, delay in prompt treatment can lead to life-threatening conditions.</p>","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11223903/pdf/","citationCount":"0","resultStr":"{\"title\":\"Acute Heart Failure as a First Manifestation of Primary Adrenal Insufficiency: Highly Lethal If Not Diagnosed!\",\"authors\":\"Maryam Heidarpour, Mohammad Mehdi Zare, Shiva Armani, Hedie Torkashvan, Sadegh Mazaheri-Tehrani, Davood Shafie\",\"doi\":\"10.1155/2024/5759629\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Primary adrenal insufficiency is an uncommon condition that manifests as nonspecific symptoms such as fatigue, weight loss, salt craving, and hyperpigmentation. Common cardiovascular presentations of AI are hypotension, arrhythmias, and syncope. However, acute heart failure is an uncommon presentation. <i>Case Presentation</i>. Here, a 26-year-old man was hospitalized with vasopressor-resistant cardiogenic shock, which was finally attributed to an adrenal crisis. His past medical history was notable for Hashimoto's disease, controlled with oral levothyroxine.</p><p><strong>Conclusion: </strong>AI should be considered among patients with cardiogenic shock who are unresponsive to conventional inotropes. Additionally, a history of autoimmune diseases may increase the suspicion of AI. Although the presentation of cardiogenic shock in a patient with undiagnosed AI is considered a rarity, delay in prompt treatment can lead to life-threatening conditions.</p>\",\"PeriodicalId\":9621,\"journal\":{\"name\":\"Case Reports in Endocrinology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2024-06-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11223903/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Case Reports in Endocrinology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2024/5759629\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Endocrinology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2024/5759629","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
背景:原发性肾上腺功能不全是一种不常见的疾病,表现为疲劳、体重减轻、嗜盐和色素沉着等非特异性症状。常见的肾上腺功能不全心血管表现为低血压、心律失常和晕厥。然而,急性心力衰竭是一种不常见的表现。病例介绍。这里有一名 26 岁的男性,因血管加压抵抗性心源性休克住院,最终被归因于肾上腺危象。其既往病史为桥本氏病,口服左甲状腺素后病情得到控制:结论:对常规肌力药物无反应的心源性休克患者应考虑使用人工肾上腺素。此外,自身免疫性疾病的病史也会增加对 AI 的怀疑。虽然未确诊 AI 的心源性休克患者很少见,但延误及时治疗可能会导致生命危险。
Acute Heart Failure as a First Manifestation of Primary Adrenal Insufficiency: Highly Lethal If Not Diagnosed!
Background: Primary adrenal insufficiency is an uncommon condition that manifests as nonspecific symptoms such as fatigue, weight loss, salt craving, and hyperpigmentation. Common cardiovascular presentations of AI are hypotension, arrhythmias, and syncope. However, acute heart failure is an uncommon presentation. Case Presentation. Here, a 26-year-old man was hospitalized with vasopressor-resistant cardiogenic shock, which was finally attributed to an adrenal crisis. His past medical history was notable for Hashimoto's disease, controlled with oral levothyroxine.
Conclusion: AI should be considered among patients with cardiogenic shock who are unresponsive to conventional inotropes. Additionally, a history of autoimmune diseases may increase the suspicion of AI. Although the presentation of cardiogenic shock in a patient with undiagnosed AI is considered a rarity, delay in prompt treatment can lead to life-threatening conditions.