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Related Experiment Videos

Acute aortic dissection associated with Sheehan's syndrome.

K Iha1, N Nagamine, Y Horikawa

  • 1Department of Cardiovascular Surgery, Chubu Tokushukai Hospital, 3-20-1 Teruya, Okinawa 904-8585, Japan.

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|October 2, 2001
PubMed
Summary

Patients with Sheehan's syndrome require enhanced corticosteroid and thyroid hormone replacement during major surgery. This case highlights the importance of adjusted hormone therapy for successful surgical outcomes.

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Area of Science:

  • Endocrinology
  • Cardiovascular Surgery
  • Hormone Replacement Therapy

Background:

  • Sheehan's syndrome is a rare condition causing pituitary hormone deficiencies.
  • Patients with Sheehan's syndrome often require long-term corticosteroid and thyroid hormone replacement.
  • Acute Stanford type A aortic dissection is a life-threatening cardiovascular emergency.

Observation:

  • A 69-year-old woman with Sheehan's syndrome presented with acute Stanford type A aortic dissection.
  • The patient had a history of long-term corticosteroid and thyroid hormone use.
  • Emergency graft replacement of the ascending aorta was performed.

Findings:

  • During cardiopulmonary bypass, methylprednisolone dosage was doubled.
  • Postoperatively, prednisolone dosage was doubled from day 1 to 6.

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  • Standard levothyroxine sodium dosage was administered orally from postoperative day 1.
  • The patient experienced an uneventful postoperative recovery.

    • Implications:

    • This case underscores the critical need for intensified steroid and thyroid hormone supplementation during major surgery in Sheehan's syndrome patients.
    • Optimized perioperative hormone management is crucial for preventing complications and ensuring favorable outcomes in this population.
    • Early and active supplementary treatment is vital for patients with Sheehan's syndrome undergoing significant surgical procedures.