Heidarpour Maryam, Shafie Davood, Eshraghi Reza, Mirjalili Seyed Reza, Bahrami Ashkan, Movahed Mohammad Reza
Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Heart Fail Rev. 2025 Jan;30(1):227-246. doi: 10.1007/s10741-024-10458-y. Epub 2024 Nov 6.
Adrenal insufficiency (AI) is a disorder in which inadequate glucocorticoid and mineralocorticoid hormone production leads to a variety of symptoms, including fatigue, weight loss, and nausea. In some patients with unknown AI, adrenal crisis-induced cardiogenic shock (ACCS) can be the first presentation, resulting in a fatal situation. The ACCS may exhibit unresponsiveness to inotropes and fluid therapy; thus, glucocorticoid administration is the primary vital intervention, making early detection of AI essential. Hence, in this study, we review the case reports demonstrating acute cardiomyopathies in the context of AI. The review addresses the suggested underlying mechanisms, including the diminished protective effects of glucocorticoids against catecholamines in AI. We also highlighted some clues to aid physicians in considering AI as a differential diagnosis in critically ill patients presenting cardiogenic shock.
肾上腺功能不全（AI）是一种疾病，其中糖皮质激素和盐皮质激素分泌不足会导致多种症状，包括疲劳、体重减轻和恶心。在一些病因不明的AI患者中，肾上腺危象诱发的心源性休克（ACCS）可能是首发表现，从而导致致命情况。ACCS可能对强心剂和液体治疗无反应；因此，给予糖皮质激素是主要的关键干预措施，早期检测AI至关重要。因此，在本研究中，我们回顾了在AI背景下显示急性心肌病的病例报告。该综述探讨了潜在机制，包括AI中糖皮质激素对儿茶酚胺的保护作用减弱。我们还强调了一些线索，以帮助医生在诊断出现心源性休克的重症患者时将AI作为鉴别诊断考虑因素。
