Addison’s Disease and Dilated Cardiomyopathy: A Case Report and Review of the Literature

Mozolevska, Viktoriya; Schwartz, A; Cheung, David; Shaikh, Bilal; Bhagirath, Kapil M.; Jassal, Davinder S.

doi:10.1155/2016/4362514

Cited by 15 publications

(17 citation statements)

References 9 publications

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“…Notably, cardiovascular manifestations of adrenal insufficiency, including dilated cardiomyopathy, arrhythmias, and Takotsubo cardiomyopathy, were rarely reported in primary and secondary adrenal insufficiency ( 4 , 9 , 10 ). The underlying mechanisms may involve downregulation of adrenergic receptors, membrane calcium transporter dysfunction, decreased phosphorylase activity, increased catecholamine levels, and disturbances in electrolyte levels ( 11 , 12 ). Furthermore, some patients' cardiac abnormalities may completely resolve after hydrocortisone replacement therapy.…”

Section: Discussionmentioning

confidence: 99%

Cardiomyopathy Associated With Tertiary Adrenal Insufficiency Manifesting as Refractory Heart Failure, Shock, and Sudden Cardiac Death: A Case Report

Wang

Luo

Feng

2021

Front. Cardiovasc. Med.

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Dilated cardiomyopathy is an etiologically heterogeneous disorder. Early diagnosis and prompt treatment of the underlying disease are of great significance. Primary and secondary adrenal insufficiency are considered quite rare causes of dilated cardiomyopathy. However, to the best of our knowledge, no case of cardiomyopathy associated with tertiary adrenal insufficiency has been reported. Herein, we described a 68-year-old woman with a 15-year history of seasonal dermatitis presented with frequent heart failure and shock. At first, she was diagnosed with idiopathic dilated cardiomyopathy, but standard heart failure and antishock treatment failed. Given her long-term use of dexamethasone for treating seasonal dermatitis, and clinical manifestations consistent with adrenal insufficiency, we tested her basal plasma cortisol, simultaneous corticotropin, and other pituitary hormones, confirming that she had tertiary adrenal insufficiency. Additionally, abdominal enhanced computed tomography revealed atrophic bilateral adrenal glands, indicating long-standing and severe adrenal insufficiency. Then hydrocortisone replacement therapy was initiated, and she recovered rapidly. During the next 2 years of follow-up, she never experienced any episodes of heart failure and shock. Unfortunately, she refused the implantation of defibrillator with cardiac resynchronization therapy (CRT-D) and died of sudden cardiac death 2 years later. Although we could not exclude the coincidence of idiopathic dilated cardiomyopathy with tertiary adrenal insufficiency with 100% certainty, her unique clinical course strongly indicated that her cardiomyopathy resulted from tertiary adrenal insufficiency. This case demonstrates that patients on corticosteroids are at risk for tertiary adrenal insufficiency, which may result in refractory cardiomyopathy and even sudden cardiac death.

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Section: Discussionmentioning

confidence: 99%

Cardiomyopathy Associated With Tertiary Adrenal Insufficiency Manifesting as Refractory Heart Failure, Shock, and Sudden Cardiac Death: A Case Report

Wang

Luo

Feng

2021

Front. Cardiovasc. Med.

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“…With an incidence of approximately 120 cases per million in the population, Addison's disease is a rare long term endocrine disorder in which the adrenal glands produce insufficient steroid hormones, including glucocorticoids (GCs) and mineralocorticoids [1][2][3][4]10]. Addison disease has many causes, the most common in the Western world being autoimmune adrenalitis, which results from destruction of the adrenal cortex.…”

Section: Discussionmentioning

confidence: 99%

“…Addison's disease is associated with a decreased production of glucocorticoid and mineralocorticoid hormones from the adrenal cortex [1,2]. Although autoimmune adrenalitis is considered to be the major cause of Addison's disease in up to 90% of diagnosed individuals, prevalent in female patients between 30 and 50 years of age, other etiologies include infectious, drug induced, and/or genetic factors [3,4].Common manifestations of this condition are hyponatremia, hyperkalemia, and/or hypoglycemia along with mucosal and skin hyperpigmentations [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Cardiogenic Shock as an Initial Presentation of Addison’s disease: A Case Report

Belabyad¹,

Khouchab²,

Boudhar³

et al. 2020

SASJM

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Addison's disease, also known as primary adrenal insufficiency, is an endocrinological condition with a deficiency in the production of glucocorticoids and mineralocorticoids from the adrenal cortex. It's a very life-threatening disease that is often overlooked due to the unspecific range of symptoms patients usually present with, thus a prompt diagnosis is essential. We present the clinical history, physical findings, laboratory results, and imaging studies of a young female presenting with cardiogenic shock revealing Addisson's disease. The association between adrenal insufficiency and cardiogenic shock and pertinent literature are reviewed.

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“…Although auto immune adrenalitis is considered to be the major cause of Addison's disease in upto 90% individuals and most commonly occurs in DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20212681 Department of Anaesthesia, Pain management/SICU/and Peri operative medicine, Doha, Qatar females between 30-50 years, other etiologies include infections, drug induced or genetic factors. 4 Peri-partum cardiomyopathy is an idiopathic cardiomyopathy that presents with heart failure secondary to left ventricular systolic dysfunction toward the end of pregnancy or in the months after delivery, in the absence of any other cause of heart failure according to Heart Failure Association of the European Society of Cardiology Working Group on PPCM 2010. PPCM is a diagnosis of exclusion.…”

Section: Introductionmentioning

confidence: 99%

Case report on peripartum cardiomyopathy in a patient with Schmidt syndrome with twin pregnancy for emergency lower segment cesarean section

Ramanathan

Khalilullah

Mathew

et al. 2021

Int J Reprod Contracept Obstet Gynecol

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Peripartum and autoimmune cardiomyopathy is an uncommon rare disorder associated with pregnancy. When it occurs association with autoimmune thyroid disorder and autoimmune adrenal insufficiency, it is eponymously referred to as Schmidt syndrome or autoimmune polyendocrine syndrome type 2 (APS type 2). Peripartum cardiomyopathy (PPCM) can be difficult to diagnose as the symptoms can be masked or misinterpreted due to the normal physiological changes during pregnancy, as the symptoms of heart failure can mimic those of pregnancy. PPCM is associated with considerable morbidity and mortality and so should not be underestimated. In this report, we are discussing the management of 32-years-old female with hypothyroidism and Addison’s disease (polyglandular syndrome type 2- Schmidt syndrome) who came for emergency lower segment cesarean section (LSCS) due to twin pregnancy (abnormal doppler of the second twin) and during the period developed pulmonary edema and was diagnosed as peripartum cardiomyopathy.

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Addison’s Disease and Dilated Cardiomyopathy: A Case Report and Review of the Literature

Cited by 15 publications

References 9 publications

Cardiomyopathy Associated With Tertiary Adrenal Insufficiency Manifesting as Refractory Heart Failure, Shock, and Sudden Cardiac Death: A Case Report

Cardiomyopathy Associated With Tertiary Adrenal Insufficiency Manifesting as Refractory Heart Failure, Shock, and Sudden Cardiac Death: A Case Report

Cardiogenic Shock as an Initial Presentation of Addison’s disease: A Case Report

Case report on peripartum cardiomyopathy in a patient with Schmidt syndrome with twin pregnancy for emergency lower segment cesarean section

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