Acute respiratory distress syndrome (ARDS) is a life-threatening disease. Different imaging techniques have been used to diagnose and guide the ventilatory management of patients with ARDS. Chest ultrasound is a reliable tool to identify interstitial syndrome, lung consolidation, lung collapse, and pleural effusion. In addition, echocardiography is essential in the diagnosis of diastolic left ventricle dysfunction and the estimation of elevated ventricle filling pressures, which is necessary before diagnosing ARDS. Therefore, combining chest and heart ultrasound assessment is useful to diagnose ARDS and guide the ventilatory management of the disease. Available data in the literature suggest that protocol-based approaches should be implemented for the purposes of diagnosis and management.

It’s evident in the literature that Addisonian crisis is tightly linked with cardiovascular manifestations, with very few cases reporting an associated between adrenal insufficiency and reversible cardiomyopathy. We report a case of a 57 years old lady who presented with an acute onset of adrenal insufficiency then developed severe heart failure that resolved post hydrocortisone administration. The clinical presentation, course of management and outcome will be discussed.

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