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Addisonian crisis following pericardiectomy
1Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Cardiovascular Surgery (London, England)
|October 1, 1994
Summary
Tuberculosis can cause constrictive pericarditis, leading to complications like hypotension after surgery. This case highlights adrenal tuberculosis as a cause of hypotension, treatable with corticosteroids.
Area of Science:
- Cardiology
- Infectious Diseases
- Endocrinology
Background:
- Tuberculosis is a frequent cause of constrictive pericarditis in developing nations.
- Surgical management of constrictive pericarditis can be complicated by tuberculosis affecting other organs.
Observation:
- A patient developed persistent hypotension unresponsive to treatment after pericardiectomy for constrictive pericarditis.
- This hypotension was diagnosed as acute adrenocortical insufficiency secondary to adrenal tuberculosis.
Findings:
- Adrenal tuberculosis can manifest as acute adrenocortical insufficiency, causing refractory hypotension post-pericardiectomy.
- Corticosteroid therapy proved effective in treating the patient's condition.
Implications:
- Low cardiac output after pericardiectomy may not always stem from myocardial issues.
- Clinicians should consider co-existent Addison's disease in patients with tuberculous pericarditis presenting with hypotension.