Hypopituitarism presenting as congestive heart failure

Abstract

Sheehan's syndrome (SS) develops as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage and is characterized by various degrees of hypopituitarism. Although the occurrence of SS is now rare, it should still be considered in any woman with a history of peripartum hemorrhage who develops manifestations of pituitary hormone deficiency any time following the event. Appropriate hormone replacement therapy results in marked clinical improvement. We present an unusual case of SS in a young lady who continued to have normal menstruation after the index event, had two spontaneous pregnancies, and was diagnosed only 11 years later when she presented to us with acute heart failure.

Panhypopituitarism in Acute Myocardial Infarction

“…First, there was panhypopituitarism presenting as AMI. Panhypopituitarism may present with heart failure,[ 2 6 7 8 ] cardiac tamponade,[ 3 4 ] Takotsubo cardiomyopathy,[ 9 ] arrhythmias,[ 5 19 ] and cardiogenic shock. [ 6 20 21 ] The prior diminished pituitary reserve could have persisted after a stressful AMI.…”

“…The intricate relationship of the pituitary and heart is well-known. While hypopituitarism makes the patients prone to cardiovascular (CV) diseases and may present with predominant CV manifestations,[ 1 2 3 4 5 6 7 8 9 10 ] several CV disorders are associated with perturbations of single or multiple hypothalamic–pituitary–end-organ axes either as a physiologic response[ 11 12 13 14 ] or pathological consequences. [ 15 16 ] We present a case of acute myocardial infarction (AMI) followed by left ventricular failure (LVF) and cardiogenic shock unresponsive to vasopressor therapy and complicated by panhypopituitarism and empty sella (ES).…”

Commercial pure titanium – A potential candidate for cardiovascular stent

“…Recently, to accomplish high edge rates while keeping radiation dose to a reasonable level, fluoroscopy utilizes the radiation dose to the picture receptor per picture at a very low, about 0.1 % of the amount used in radiography. Fluoroscopic images show a reversed grayscale (dark/white is turned around) distinguished from standard radiographs [37].…”