A Case of Adrenocorticotropic Hormone Deficiency after Surgery for Cardiac Valvular Disease

(Department of Cardiovascular Surgery, First Department of Internal Medicine, Faculty of Medicine, Oita University, Oita, Japan)

Aiko Sato Hirofumi Anai Tomoyuki Wada
Hirotsugu Hamamoto Toru Shimaoka Takashi Shuto
Takeshi Sakaguchi Koro Goto Hironobu Yoshimatsu
Shinji Miyamoto
A 59-year-old man was admitted to our hospital with severe mitral incompetence. Mitral valve repair, tricuspid annuloplasty and the Maze procedure were performed. After weaning from cardiopulmonary bypass, his systolic blood pressure(SBP)dropped to 40mmHg. Immediate administration of catecholamines markedly increased SBP but his continuing low blood pressure required additional treatment with vasopressin and hydrocortisone. On postoperative day 12 in the general ward, he suddenly lapsed into an intractable hypoglycemic coma. Endocrine function tests revealed adrenocorticotropic hormone deficiency. Since the time of writing has been doing well with 20 mg of hydrocortisone.
  Jpn. J. Cardiovasc. Surg. 39:187-190(2010)

Keywords:cardiac valvular disease, adrenocorticotropic hormone deficiency, hypoglycemia, hypotension