Panhypopituitarism Mimicking Acute Coronary Syndrome

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  • Sugi Yoshito
    Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
  • Mori Kenta
    Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
  • Kobayashi Takashi
    Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
  • Arai Naoki
    Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
  • Okano Mitsumasa
    Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
  • Muramae Naokazu
    Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
  • Oshita Toshihiko
    Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
  • Otsui Kazunori
    Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
  • Sakaguchi Kazuhiko
    Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan

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Abstract

<p>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. </p>

Journal

  • Internal Medicine

    Internal Medicine 62 (4), 559-564, 2023-02-15

    The Japanese Society of Internal Medicine

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