PANHYPOPITUITARISM, HYPONATREMIA AND LONG QT INTERVAL SYNDROME - A CASE-REPORT

Acquired prolongation of QT interval in the conventional electrocardio gram has been reported in many medical problems including coronary art ery disease, mitral valve prolapse, drug idiosyncracies especially ant iarrhythmic and psychotropic drugs, electrolyte disturbances and endoc rine abnormalities as in hypothyroidism. However, there is a body of e vidence in the literature indicating that this problem is relatively u ncommon in simple cases of hypothyroidism. We report a 60 year old Sau di patient who was transferred from the regular ward to the Coronary C are Unit (CCU) with severe hyponatremia, clinical manifestration of pa nhypopituitarism and prolonged QTc (730 ms). She developed a short par oxysm of Torsades-de-Pointes ventricular tachycardia early after the t ransfer to the CCU. Panhypopituitarism was documented through specific endocrinological investigations. The prolongation of QT interval and the hyponatremia were normalized shortly after the initiation of hormo nal replacement therapy. We feel that adrenocortical insufficiency as a part of panhypopituitarism is a probable contributory factor in the development of this electrophysiological abnormality.