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Adrenal Crisis-Induced Cardiogenic Shock (Accs): A Comprehensive Review Publisher Pubmed



Heidarpour M1 ; Shafie D2 ; Eshraghi R3 ; Mirjalili SR4 ; Bahrami A3 ; Movahed MR5, 6
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. Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
  4. 4. Yazd Cardiovascular Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  5. 5. University of Arizona Sarver Heart Center, Tucson, United States
  6. 6. University of Arizona College of Medicine, Phoenix, United States

Source: Heart Failure Reviews Published:2025


Abstract

Adrenal insufficiency (AI) is a disorder in which inadequate glucocorticoid and mineralocorticoid hormone production leads to a variety of symptoms, including fatigue, weight loss, and nausea. In some patients with unknown AI, adrenal crisis-induced cardiogenic shock (ACCS) can be the first presentation, resulting in a fatal situation. The ACCS may exhibit unresponsiveness to inotropes and fluid therapy; thus, glucocorticoid administration is the primary vital intervention, making early detection of AI essential. Hence, in this study, we review the case reports demonstrating acute cardiomyopathies in the context of AI. The review addresses the suggested underlying mechanisms, including the diminished protective effects of glucocorticoids against catecholamines in AI. We also highlighted some clues to aid physicians in considering AI as a differential diagnosis in critically ill patients presenting cardiogenic shock. © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024.
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