Document Detail


Cushing's syndrome patient who exhibited congestive heart failure.
MedLine Citation:
PMID:  17646730     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cushing's Syndrome (CS) may sometimes lead to dilated cardiomyopathy, even though this condition can be partially or completely reversed after treatment. In this article we report the case of a 28-yr-old woman with CS secondary to adrenal adenoma who exhibited congestive heart failure as an initial symptom. Two weeks before being admitted to our hospital, the patient started complaining of shortness of breath, orthopnea, paroxysmal nocturnal dyspnea and generalized edema. A physical examination did not reveal signs of hypercortisolism. Chest auscultation revealed bilateral diffused crepitation; blood pressure was 180/120 mmHg with heart rate of 90 beats/min. A chest X-ray showed a cardiac shade enlargement due to congestive heart failure. Transthoracic echocardiography demonstrated a dilated left ventricle and an impaired left ventricular systolic function. The patient's urinary cortisol excretion was elevated and circadian rhythm of cortisol was absent. ACTH level was low. In addition, plasma cortisol failed to decrease after administration of dexamethasone. An abdominal magnetic resonance imaging scan showed a 7-cm right adrenal mass. The patient was administered oxygen, spironolactone, ACE-inhibitor and the signs and symptoms of heart failure gradually improved. A laparoscopic right adrenalectomy was performed and pathological examination of the gland showed a benign adrenocortical adenoma. After the adrenalectomy the patient was started on hydrocortisone therapy and 5 months later the wall thickness of the left ventricle was within normal range and the patient's blood pressure was 130/80 mmHg. In conclusion we report the case of heart failure as the main clinical symptom in CS secondary to adrenal adenoma.
Authors:
L Petramala; P Battisti; G Lauri; L Palleschi; D Cotesta; M Iorio; G De Toma; S Sciomer; C Letizia
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  30     ISSN:  1720-8386     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-07-24     Completed Date:  2008-04-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  525-8     Citation Subset:  IM    
Affiliation:
Department of Clinical Sciences, Day Hospital of Internal Medicine and Arterial Hypertension, University La Sapienza, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adrenocortical Adenoma / complications*,  diagnosis,  pathology,  surgery
Adult
Cushing Syndrome* / complications,  diagnosis,  etiology,  surgery
Echocardiography
Female
Heart Failure / etiology*
Humans
Magnetic Resonance Imaging
Male

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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