Sheehan Syndrome Leading to Acute Systolic and Diastolic Heart Failure: A Case Report
TLDR Untreated Sheehan's Syndrome caused severe heart failure in a woman, which improved with hormone and heart failure treatment.
A 28-year-old woman with a history of hypothyroidism presented with symptoms including weakness, cold intolerance, nausea, and vomiting, and was found to have hypotension, hypoglycemia, and hypothermia. She had a history of amenorrhea, hair loss, fatigue, and facial swelling since her last pregnancy 6 years prior, without a history of post-partum hemorrhage. An MRI revealed flattening of her anterior pituitary, indicating Sheehan's Syndrome, which had gone untreated and led to severe combined systolic and diastolic heart failure with an ejection fraction of 10%. Her heart failure was attributed to panhypopituitarism, and she was treated with hormone replacement therapy (hydrocortisone and levothyroxine) and medications for heart failure (diuretics, digoxin, and an ACE inhibitor). The case highlights that panhypopituitarism can lead to heart failure, which is a rare occurrence, and that cardiac function can improve with treatment of the underlying endocrine deficiencies. Increased awareness of Sheehan's Syndrome as a potential cause of dilated cardiomyopathy can improve diagnosis and treatment outcomes for this reversible condition.
