Lesson of the week: Hypopituitarism after coronary artery bypass grafting   Commentary: Hypoadrenalism should also be considered in cases of persistent hyponatraemia

Davies, J. S.; Scanlon, M. F.; Belchetz, P. E.

doi:10.1136/bmj.316.7132.682

Cited by 19 publications

(3 citation statements)

References 12 publications

(9 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This can present acutely as neuro-ophthalmological complications secondary to necrosis, Haemorrhage or acute swelling in a pre-existing pituitary tumour 13 and delayed presentation may be in the form of hypogonadism. Non-pulsatile flow, microemboli during bypass and haemodynamic changes in the brain during bypass are supposed to be the contributory causes of pituitary infarction after CABG 14 …”

Section: Discussionmentioning

confidence: 99%

Perioperative management in a patient with panhypopituitarism – evidence based approach: a case report

Raut

Kar

Maheshwari

et al. 2019

European Heart Journal - Case Reports

View full text Add to dashboard Cite

Background Hypopituitarism is characterized by partial or complete deficiency of vital endocrinological hormones such as steroid and thyroid hormones. Generally, normal individual can exhibit 2- to 10-folds rise in serum cortisol levels during stressful period. But patients with panhypopituitarism are more prone to develop metabolic and haemodynamic instability particularly during stressful perioperative period. This can potentially increase significant morbidity and mortality. Case summary A 62-year-old female patient presented with breathlessness on exertion. Her coronary angiography revealed critical triple vessel coronary artery disease, and she was scheduled for coronary artery bypass grafting surgery. She had been diagnosed with Sheehan’s syndrome (postpartum hypopituitarism) since 20 years. She was taking steroid and thyroxine regularly. After uneventful off-pump coronary artery bypass grafting surgery, patient had severe haemodynamic compromise with Addisonian crisis in the post-operative phase. Left ventricular dysfunction was refractory to maximal inotropic therapy. Addisonian crisis was treated with higher ‘Stress doses’ of intravenous hydrocortisone and routine oral thyroxin. Discussion Acute Addisonian crisis after stressful surgery is a life-threatening complication. Evidence-based approach plays an important role in appropriate biochemical assessments and specific therapeutic decisions regarding hormonal over-replacement or under-replacement in the perioperative period.

show abstract

Section: Discussionmentioning

confidence: 99%

Perioperative management in a patient with panhypopituitarism – evidence based approach: a case report

Raut

Kar

Maheshwari

et al. 2019

European Heart Journal - Case Reports

View full text Add to dashboard Cite

show abstract

“…Pituitary apoplexy is clinically defined as an acute, life‐threatening neuroendocrine emergency, which invariably requires immediate neurosurgical intervention with endocrine support. Pituitary infarction has recently been reported following coronary artery bypass graft (CABG) 1 . We report a case of pituitary apoplexy following CABG who was completely asymptomatic in the intra‐ and postoperative periods.…”

mentioning

confidence: 92%

“…Pituitary infarction has recently been reported following coronary artery bypass graft (CABG). 1 We report a case of pituitary apoplexy following CABG who was completely asymptomatic in the intra-and postoperative periods.…”

mentioning

confidence: 98%

Asymptomatic Pituitary Apoplexy After Aortocoronary Bypass Surgery

Bhattacharyya

Tymms

Naqvi

1999

Int J Clinical Practice

View full text Add to dashboard Cite

SUMMARYPituitary apoplexy usually presents with acute neuro‐ophthalmological complications that require urgent neurosurgical intervention. We present a case of pituitary apoplexy following aortocoronary bypass surgery that was asymptomatic until the patient presented with features of hormonal deficiency three months later. Only one case of pituitary apoplexy has been described in the literature following cardiac surgery that did not require operative intervention. We discuss the aetiology of pituitary apoplexy and the possible mechanisms for such an event after cardiac surgery. Although this is rare, any unusual feature after operation such as lethargy or erectile dysfunction should remind us of hypopituitarism.

show abstract

Thyroid Disorders in Older Adults

Pandya,

Hames

2023

Geriatric Medicine

View full text Add to dashboard Cite

Lesson of the week: Hypopituitarism after coronary artery bypass grafting Commentary: Hypoadrenalism should also be considered in cases of persistent hyponatraemia

Cited by 19 publications

References 12 publications

Perioperative management in a patient with panhypopituitarism – evidence based approach: a case report

Perioperative management in a patient with panhypopituitarism – evidence based approach: a case report

Asymptomatic Pituitary Apoplexy After Aortocoronary Bypass Surgery

Thyroid Disorders in Older Adults

Contact Info

Product

Resources

About