An Interesting Case of Adrenal Insufficiency with Cardiomyopathy during Index Adrenal Crisis Presentation Followed by Recurrent Pericarditis - Abstract
Adrenal insufficiency commonly manifests as vague symptoms with or without abnormal lab findings such as hyponatremia, hyperkalemia, hypercalcemia or hypoglycemia. It
is very crucial to diagnose adrenal insufficiency in the early stages, as the patient may acutely decompensate due to hypotension, shock, cardiac dysfunction, or respiratory failure.
We present a unique case of adrenal insufficiency in a 27-year-old woman who tends to have some degree of cardiac complication with every adrenal crisis episode. Her initial
manifestation of adrenal crisis was complex with pericardial effusion and cardiogenic shock from toxic cardiomyopathy due to neurohormonal stress requiring intra-aortic balloon
pump and vasopressor/inotropic support. Her cardiac function fully recovered within a few days and returned to baseline prior to discharge. After 1 year she was noted to have
a moderate pericardial effusion without cardiac dysfunction during another adrenal crisis episode while being treated for pneumonia. This episode of pericardial effusion resolved
within a few days. Since then, she has had multiple episodes of chest pain from pericarditis unrelated to adrenal crisis. This is a rare case of predominant cardiac involvement with
every adrenal crisis episode followed by recurrent pericarditis.