HyperCKemia and Sheehan's syndrome mimicking acute coronary syndrome

A 56-year-old lady presented with chest discomfort for 2 days. Electrocardiography showed deep T wave inversions in the anterior leads. Cardiac Troponin was elevated. Her creatine phosphokinase (CPK) was disproportionately high compared to the elevation of creatine kinase myocardial band (CKMB). The patient had severe hyponatremia which was due to decreased cortisol levels. Her coronary angiogram was normal. She was a known hypothyroid, other hormonal analyses showed low levels of cortisol, Adreno Corticotropic Hormone (ACTH), Follicle Stimulating Hormone (FSH), and Luteinizing Hormone (LH), hence diagnosis of panhypopituitarism, Sheehan's syndrome was made. The patient was stabilized and discharged on oral steroids.