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



Heidarpour M¹ ; Zare MM^{1, 2} ; Armani S² ; Torkashvan H² ; Mazaheritehrani S^{2, 3, 4} ; Shafie D²
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.