The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Stress-Induced Cardiomyopathy in Sheehan's Syndrome

시한 증후군 환자에서 발생한 스트레스성 심근병증

  • Lee, Seoung-Ho (Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Kyu-Jin (Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Bo-Yeon (Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Jung, Chan-Hee (Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Mok, Ji-Oh (Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Kang, Sung-Koo (Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Chul-Hee (Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine)
  • 이승호 (순천향대학교 의과대학 순천향대학교 부천병원 내과) ;
  • 김규진 (순천향대학교 의과대학 순천향대학교 부천병원 내과) ;
  • 김보연 (순천향대학교 의과대학 순천향대학교 부천병원 내과) ;
  • 정찬희 (순천향대학교 의과대학 순천향대학교 부천병원 내과) ;
  • 목지오 (순천향대학교 의과대학 순천향대학교 부천병원 내과) ;
  • 강성구 (순천향대학교 의과대학 순천향대학교 부천병원 내과) ;
  • 김철희 (순천향대학교 의과대학 순천향대학교 부천병원 내과)
  • Received : 2013.09.26
  • Accepted : 2014.01.10
  • Published : 2014.09.01
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Abstract

Cardiogenic shock after stress-induced cardiomyopathy is very rare and serious, and a reversible, clinical consequence of untreated adrenal insufficiency that is attributable to Sheehan's syndrome. A 53-year-old female presented with confusion, congestive heart failure, and hypotension. Endocrine testing, prior medical history, and brain MRI confirmed the presence of hypopituitarism and secondary adrenal insufficiency owing to undiagnosed Sheehan's syndrome. After glucocorticoid replacement therapy, her cardiac function recovered completely. Stress-induced cardiomyopathy should be considered as a possible cause of unexplained heart failure in patients with Sheehan's syndrome and adrenal insufficiency.

이전에 진단받지 못했던 시한 증후군 환자에서 급성부신기능부전과 스트레스성 심근병증이 병발하였고 적절한 호르몬 보충 치료 후 심장 기능이 정상으로 회복된 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Kelestimur F. Sheehan's syndrome. Pituitary 2003;6:181-188. https://doi.org/10.1023/B:PITU.0000023425.20854.8e
  2. Bybee KA, Prasad A. Stress-related cardiomyopathy syndromes. Circulation 2008;118:397-409. https://doi.org/10.1161/CIRCULATIONAHA.106.677625
  3. Richard C. Stress-related cardiomyopathies. Ann Intensive Care 2011;1:39. https://doi.org/10.1186/2110-5820-1-39
  4. Bao SS, Fisher SJ. Repairing a "broken heart" with hormone replacement therapy: case report of cardiogenic shock due to undiagnosed pituitary insufficiency. Endocr Pract 2012;18:e26-31. https://doi.org/10.4158/EP11284.CR
  5. Laway BA, Alai MS, Gojwari T, Ganie MA, Zargar AH. Sheehan syndrome with reversible dilated cardiomyopathy. Ann Saudi Med 2010;30:321-324. https://doi.org/10.4103/0256-4947.65269
  6. Dokmetas HS, Kilicli F, Korkmaz S, Yonem O. Characteristic features of 20 patients with Sheehan's syndrome. Gynecol Endocrinol 2006;22:279-283. https://doi.org/10.1080/09513590600630504
  7. Adamopoulos S, Parissis JT, Paraskevaidis I, et al. Effects of growth hormone on circulating cytokine network, and left ventricular contractile performance and geometry in patients with idiopathic dilated cardiomyopathy. Eur Heart J 2003;24:2186-2196. https://doi.org/10.1016/S0195-668X(03)00480-9
  8. Ukita C, Miyazaki H, Toyoda N, Kosaki A, Nishikawa M, Iwasaka T. Takotsubo cardiomyopathy during acute adrenal crisis due to isolated adrenocorticotropin deficiency. Intern Med 2009;48:347-352. https://doi.org/10.2169/internalmedicine.48.1662
  9. Galli E, Pingitore A, Iervasi G. The role of thyroid hormone in the pathophysiology of heart failure: clinical evidence. Heart Fail Rev 2010;15:155-169. https://doi.org/10.1007/s10741-008-9126-6
  10. Wittstein IS, Thiemann DR, Lima JA, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med 2005;352:539-548. https://doi.org/10.1056/NEJMoa043046

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