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J Cardiovasc Med (Hagerstown) · Sep 2007
Case ReportsRelative adrenal insufficiency in severe congestive heart failure with preserved systolic function: a case report.
- Joshua D Lovelock, Sandra Coslet, Marie Johnson, Stuart Rich, and Mardi Gomberg-Maitland.
- Department of Cardiology, University of Chicago Hospitals, 5841 S. Maryland Avenue, Chicago, IL 60637, USA.
- J Cardiovasc Med (Hagerstown). 2007 Sep 1; 8 (9): 754-7.
AbstractRelative adrenal insufficiency in critically ill patients is an important syndrome in septic shock. The insufficient stress response of the hypothalamic-pituitary-adrenal axis in acute illness contributes to hemodynamic instability. Treatment of this state in septic shock improves patient outcomes. In this report, we describe the case of a patient with severe diastolic dysfunction who presented in cardiogenic shock associated with relative adrenal insufficiency and had a complete recovery with corticosteroid replacement. Alteration of the hypothalamic-pituitary-adrenal axis may be more prevalent than suspected in end-stage heart failure, and the diagnosis and treatment of this syndrome may ultimately improve outcomes in a subgroup of heart failure patients.
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