Harris Chad L, Khalid Mazin, Hashmi Arsalan, Shani Jacob, Malik Bilal A
Internal Medicine, Maimonides Medical Center, New York, USA.
Cardiology, Maimonides Medical Center, New York, USA.
Cureus. 2021 Apr 11;13(4):e14420. doi: 10.7759/cureus.14420.
We report a case of a 36-year-old male who presented to the emergency department with complaints of weakness. On presentation the patient was hypotensive, hyperkalemic, and hyponatremic. The patient experienced a sudden cardiac arrest in the computed tomography (CT) scanner moments after arrival. Electrocardiogram (EKG) demonstrated PR prolongation and widened QRS. Echocardiogram demonstrated a left ventricular ejection fraction of 26%-30% with evidence of severe hypokinesis of the mid antero-septal and inferior-septal segments of the left ventricle. CT of the chest, abdomen, and pelvis demonstrated hypoplastic/atrophic adrenal glands. Total cortisol level was undetectable by lab measurement. The patient was diagnosed with stress cardiomyopathy secondary to adrenal crisis. He was managed with hydrocortisone and eventually made a full clinical recovery and improvement in left ventricular ejection fraction. This article references the rarity of this phenomenon and its relevance to early clinical detection.
我们报告一例36岁男性，因虚弱症状前往急诊科就诊。就诊时患者血压低、血钾高、血钠低。患者到达后不久在计算机断层扫描（CT）扫描仪中突发心脏骤停。心电图（EKG）显示PR间期延长和QRS波增宽。超声心动图显示左心室射血分数为26%-30%，左心室前间隔和下间隔中段有严重运动减弱的证据。胸部、腹部和骨盆的CT显示肾上腺发育不全/萎缩。实验室检测未检测到总皮质醇水平。该患者被诊断为继发于肾上腺危象的应激性心肌病。他接受了氢化可的松治疗，最终临床完全康复，左心室射血分数有所改善。本文提及了这种现象的罕见性及其与早期临床检测的相关性。
