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Acute Heart Failure As a First Manifestation of Primary Adrenal Insufficiency: Highly Lethal If Not Diagnosed! Publisher



Heidarpour M1 ; Zare MM1, 2 ; Armani S2 ; Torkashvan H2 ; Mazaheritehrani S2, 3, 4 ; Shafie D2
Authors
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Authors Affiliations
  1. 1. Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Case Reports in Endocrinology Published:2024


Abstract

Background. Primary adrenal insufficiency is an uncommon condition that manifests as nonspecific symptoms such as fatigue, weight loss, salt craving, and hyperpigmentation. Common cardiovascular presentations of AI are hypotension, arrhythmias, and syncope. However, acute heart failure is an uncommon presentation. Case Presentation. Here, a 26-year-old man was hospitalized with vasopressor-resistant cardiogenic shock, which was finally attributed to an adrenal crisis. His past medical history was notable for Hashimoto's disease, controlled with oral levothyroxine. Conclusion. AI should be considered among patients with cardiogenic shock who are unresponsive to conventional inotropes. Additionally, a history of autoimmune diseases may increase the suspicion of AI. Although the presentation of cardiogenic shock in a patient with undiagnosed AI is considered a rarity, delay in prompt treatment can lead to life-threatening conditions. © 2024 Maryam Heidarpour et al.
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