Adult reversible cardiomyopathy with pituitary adrenal insufficiency caused by empty sella - A case report

The authors report a first case of reversible cardiomyopathy in an adult wi th adrenal insufficiency. A 62-year-old man was administered to hospital be cause of congestive heart failure. The electrocardiagram showed prolonged Q T interval and negative T wave on the right precordial leads and frequent m ultifocal ventricular premature contractions. On the echocardiogram, the le ft ventricle was revealed to be diffusely hypokinetic with remarkable enlar gement. (201)Thallium single photon emission computed tomography (SPECT) re vealed multiple flow defects in the left ventricular wall. He also had pitu itary adrenal insufficiency secondary to an empty sella, which was diagnose d by hormonal studies and magnetic resonance images of the brain. After the replacement therapy with hydrocortisone, heart failure was sufficiently re solved. Abnormal flow defects in the myocardium on SPECT were also improved . To the authors' knowledge, adrenal insufficiency with cardiomyopathy has not been previously described in adult patients.