Relative adrenal insufficiency in severe congestive heart failure with preserved systolic function: A case report

Joshua D. Lovelock, Sandra Coslet, Marie Johnson, Stuart Rich, Mardi Gomberg-Maitland*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Relative 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.

Original languageEnglish (US)
Pages (from-to)754-757
Number of pages4
JournalJournal of Cardiovascular Medicine
Volume8
Issue number9
DOIs
StatePublished - Sep 1 2007

Keywords

  • Adrenal insufficiency
  • Cardiogenic shock
  • Congestive heart failure
  • Critical care
  • Diastolic dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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