Untreated Addison's Disease Complicated by Pulmonary Congestion due to Left Ventricular Failure

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

“…The clinical presentation of Addison's disease encompasses a multitude of systemic symptoms including fatigue, weight loss, salt craving, and joint and back discomfort [1–3, 9]. Individuals with primary adrenal insufficiency may also experience a number of cardiovascular symptoms including hypotension, arrhythmias, and congestive heart failure [4–8]. In fact, the development of a dilated cardiomyopathy due to Addison's disease is extremely rare [4–8].…”

“…Individuals with primary adrenal insufficiency may also experience a number of cardiovascular symptoms including hypotension, arrhythmias, and congestive heart failure [4–8]. In fact, the development of a dilated cardiomyopathy due to Addison's disease is extremely rare [4–8]. Although the exact etiology of heart failure due to Addison's disease remains unknown, a number of potential mechanisms include (i) reduced effects of cortical hormones on the LV myocardium; (ii) poor alimentation with low glycogen reserves; (iii) hemoconcentration, low blood volume, and reduced coronary blood flow; and (iv) disturbances in electrolyte levels [9].…”

“…After a systematic review of the literature of all adult cases of Addison's disease and dilated cardiomyopathy, a total of 6 published cases (including the current report) were identified as shown in Table 1 [4–8]. The mean age was 38 years (range 21–53) with a male to female ratio of 2 : 1.…”

“…Common manifestations of this condition are hyponatremia, hyperkalemia, and/or hypoglycemia along with mucosal and skin hyperpigmentations [2, 3]. Although cardiovascular manifestations of Addison's disease include hypotension, syncope, and arrhythmias, the development of a dilated cardiomyopathy and heart failure are an uncommon life-threatening complication [4–8]. We describe a rare case of a 30-year-old male with a dilated cardiomyopathy in the context of Addison's disease and review all 6 adult cases of this cardiac manifestation published to date [4–8].…”

“…Although cardiovascular manifestations of Addison's disease include hypotension, syncope, and arrhythmias, the development of a dilated cardiomyopathy and heart failure are an uncommon life-threatening complication [4–8]. We describe a rare case of a 30-year-old male with a dilated cardiomyopathy in the context of Addison's disease and review all 6 adult cases of this cardiac manifestation published to date [4–8]. We evaluate the clinical presentation, treatment, and outcomes of these cases and discuss the diagnosis, pathophysiology, and treatment of this rare hormone mediated cardiac disorder.…”