Reversible cardiomyopathy as a rare presentation of sheehan’s syndrome-case report and review of literature

Authors

  • Mohmmad Hayat Bhat Department of Medicine, Government Medical College Srinagar, Jammu and Kashmir, India
  • Farhana Bagdadi Department of Medicine, Government Medical College Srinagar, Jammu and Kashmir, India
  • Asma Rafi Department of Medicine, Government Medical College Srinagar, Jammu and Kashmir, India
  • Parvaiz Ahmad Shah Department of Medicine, Government Medical College Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20175199

Keywords:

Hypopituitarism, Reversible dilated cardiomyopathy, Sheehan’s

Abstract

Sheehan’s syndrome is a clinical condition characterised by post-partum panhypopitutarism caused by necrosis of the pituitary gland. The hypervascularity of the pituitary gland during pregnancy makes it vulnerable to arterial pressure changes and prone to haemorrhage in the post-partum period. The cardinal features are lethargy, secondary amenorrhea and lactational failure. The diagnosis in immediate post-partum period is difficult and require a high degree of suspicion. Cardiac involvement in sheehan’s syndrome is known but rare.

We hereby present a case of post-partum cardiomyopathy with relatively poor response to anti failure treatment. Patient however responded to hormone replacement including glucocorticoids and levothyroxine, after proper confirmation of the hypopituitary state. Cardiac dysfunction markedly reversed with the institution of replacement therapy.

References

Kaufman MS, Ganti L, Holmes J, Schachel P. First Aid for the Obstetrics and Gynecology Clerkship. McGraw Hill Professional; 2010.

Schrager S, Sabo L. Sheehan syndrome: a rare complication of postpartum hemorrhage. J Americ Board of Family Practice. 2001;14(5):389-91.

Sheehan HL. The incidence of postpartum hypopituitarism. Am J Obstet G. 1954;68(1):202-23.

Zargar AH, Masoodi SR, Laway BA, Shah NA, Salahuddin M, Siddiqi MA, Kour S. Clinical spectrum of Sheehan's syndrome. Annals of Saudi medicine. 1996;16(3):338-41.

Laway BA,Alai MS,Gojwari T,Ganie MA, Zargar AH. Sheehan’s syndrome with reversible dilated cardiomyopathy.Ann Saudi Med. 2010;30(4):321-4.

Vasanti N, Asha H, Paul T, Sunithi M. Sheehans syndrome with reversible cardiomyopathy. A case reports. 2014;3(5):44.

Wang SY, Hsu SR, Su SL, Tu ST. Sheehan's syndrome presenting with early postpartum congestive heart failure. Journal of the Chinese Medical Association. 2005;68(8):386-91.

Bao S, Fisher S. Repairing a" broken heart" with hormone replacement therapy: case report of cardiogenic shock due to undiagnosed pituitary insufficiency. Endocrine Practice. 2011;18(2):e26-31.

Parikh A, Ezzat S. Complete anterior pituitary failure and postpartum cardiomyopathy. Endocrine practice. 2006;12(3):284-7.

Goswami R, Kochupillai N, Crock PA, Jaleel A, Gupta N. Pituitary autoimmunity in patients with Sheehan’s syndrome. Journal Clinic Endocrinol Metabol. 2002;87(9):4137-41.

Sundstrom JB, Fett JD, Carraway RD, Ansari AA. Is peripartum cardiomyopathy an organ-specific autoimmune disease? Autoimmunity reviews. 2002;1(1):73-7.

Wani AI, Farooqui KJ, Bashir MI, Lone AA, Masoodi SR. Autoimmune polyglandular syndrome type 1 with reversible dilated cardiomyopathy: complete recovery after correction of hypocalcemia and hypocortisolemia. J Peadiatr Endocrinol Metab. 2013;26(3-4):373-6.

Bhat MA, Laway BA, Allaqaband FA, Kotwal SK, Wani IA, Banday KA. Acute renal Failure: A rare presentation of Sheehan’s syndrome. Indian J Endo and Metab. 2012;16(2):306-9.

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Published

2017-11-22