Coronary artery disease in a patient with Addison's disease: a case report and literature review.


Journal

BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539

Informations de publication

Date de publication:
29 01 2023
Historique:
received: 14 02 2022
accepted: 18 01 2023
entrez: 28 1 2023
pubmed: 29 1 2023
medline: 1 2 2023
Statut: epublish

Résumé

Addison's disease which is due to dysfunction of the adrenal gland, with abnormal secretion of glucocorticoids and mineralocorticoids, is rare. By inducing inflammation and disorders of water and electrolyte metabolism, Addison's disease may accelerate progression of co-existed cardiovascular diseases. Addison's disease combined with cardiovascular disease is infrequent, only 10 cases in the literature. We reported a 51-year-old male patient with unstable angina pectoris and hypotension. Changes on coronary angiography within 2 years suggested rapid progression of coronary artery disease in a patient with low cardiovascular risk. An additional clue of skin hyperpigmentation, fatigue and further examination confirmed the diagnosis of Addison's disease caused by adrenal tuberculosis. After hormone replacement treatment, the frequency and severity of the angina pectoris were alleviated significantly, as were hypotension, hyperpigmentation and fatigue. The combination of Addison's disease and coronary artery disease in one patient is rare. Addison's disease can induce inflammation and disorders of water and electrolyte metabolism, which may further accelerate the course of coronary artery disease. Meanwhile, the hypotension in Addison's disease may affect the coronary blood flow, which may result in an increased susceptibility to unstable angina in the presence of coronary stenosis. So, we should analyze comprehensively if the coronary artery disease progress rapidly.

Sections du résumé

BACKGROUND
Addison's disease which is due to dysfunction of the adrenal gland, with abnormal secretion of glucocorticoids and mineralocorticoids, is rare. By inducing inflammation and disorders of water and electrolyte metabolism, Addison's disease may accelerate progression of co-existed cardiovascular diseases. Addison's disease combined with cardiovascular disease is infrequent, only 10 cases in the literature.
CASE PRESENTATION
We reported a 51-year-old male patient with unstable angina pectoris and hypotension. Changes on coronary angiography within 2 years suggested rapid progression of coronary artery disease in a patient with low cardiovascular risk. An additional clue of skin hyperpigmentation, fatigue and further examination confirmed the diagnosis of Addison's disease caused by adrenal tuberculosis. After hormone replacement treatment, the frequency and severity of the angina pectoris were alleviated significantly, as were hypotension, hyperpigmentation and fatigue.
CONCLUSIONS
The combination of Addison's disease and coronary artery disease in one patient is rare. Addison's disease can induce inflammation and disorders of water and electrolyte metabolism, which may further accelerate the course of coronary artery disease. Meanwhile, the hypotension in Addison's disease may affect the coronary blood flow, which may result in an increased susceptibility to unstable angina in the presence of coronary stenosis. So, we should analyze comprehensively if the coronary artery disease progress rapidly.

Identifiants

pubmed: 36709280
doi: 10.1186/s12872-023-03079-0
pii: 10.1186/s12872-023-03079-0
pmc: PMC9884407
doi:

Types de publication

Review Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

54

Informations de copyright

© 2023. The Author(s).

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Auteurs

Ruohan Zhao (R)

Department of Cardiology, Cardiovascular Institute of Chengdu Third People's Hospital/The Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610031, China.

Suxin Luo (S)

Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

Shuzhen Wang (S)

Department of Cardiology, Cardiovascular Institute of Chengdu Third People's Hospital/The Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610031, China.

Yi Wen (Y)

Health Management Centre, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China.

Feng Xiong (F)

Department of Cardiology, Cardiovascular Institute of Chengdu Third People's Hospital/The Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610031, China. xiongfengcd3yy@163.com.

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