Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Intern Med. 2023 Feb 15;62(4):559-564. doi: 10.2169/internalmedicine.0031-22. Epub 2022 Jun 14.
A 59-year-old man suspected of having myocardial infarction with sinus bradycardia, a decreased blood pressure, and ST-change on an electrocardiogram was referred to our hospital's emergency department. Emergent coronary angiography revealed no significant findings. However, the patient experienced shock and required intensive care. Curiosity rose when his urination volume was not disturbed; we suspected hormonal abnormalities. A hormonal examination and imaging analysis revealed panhypopituitarism caused by a Rathke's cyst. Appropriate hormonal replacement therapy improved his symptoms and led to normalization of his electrocardiogram findings. Acute coronary syndrome (ACS) is a fatal disease; however, clinicians must not discount panhypopituitarism, as it may mimic ACS symptoms.
一位 59 岁男性，因疑似心肌梗死合并窦性心动过缓、低血压和心电图 ST 段改变而被转至我院急诊科。紧急冠状动脉造影未发现明显异常。然而，患者出现休克，需要重症监护。由于他的尿量未受影响，我们怀疑存在激素异常。激素检查和影像学分析显示，他患有 Rathke 囊肿引起的全垂体功能减退症。适当的激素替代治疗改善了他的症状，并使心电图检查结果恢复正常。急性冠状动脉综合征（ACS）是一种致命性疾病；然而，临床医生不能忽视全垂体功能减退症，因为它可能模仿 ACS 症状。
