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범뇌하수체저하증의 호르몬 대체요법 중단 후 발생한 스트레스 심근병증
남승완 ( Seoung Wan Nam ),이준원 ( Jun-won Lee ),심정한 ( Jeong Han Sim ),백현성 ( Hyun Sung Pack ),임창조 ( Changjo Im ),임정수 ( Jung Soo Lim ),안성균 ( Sung Gyun Ahn ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.2
Stress induced cardiomyopathy (SC) is characterized by transient left ventricular (LV) dysfunction in the absence of coronary artery disease. We report on a patient with panhypopituitarism who developed SC resulting from withdrawal of hormonal replacement therapy (HRT). A 52-year-old male visited our hospital for progressively worsening dyspnea. The patient had discontinued HRT 7 days ago, which had been administered for 18 months after transsphenoidal adenomectomy for pituitary macroadenoma. Initial electrocardiogram showed marked sinus bradycardia. Transthoracic echocardiography showed apical ballooning with an LV ejection fraction of 25%. No significant obstructive lesions were observed on coronary angiography. With a clinical diagnosis of SC associated with panhypopituitarism, HRT was restarted, including glucocorticoid and thyroxine, along with standard heart failure management. His LV function had normalized at 2-month follow-up. He remains asymptomatic and administration of beta-blocker and angiotensin converting enzyme inhibitor were discontinued He currently only requires HRT.