Korean J Thorac Cardiovasc Surg.  2004 Jul;37(7):601-605.

Adrenal Crisis after Off-pump Coronary Artery Bypass Surgery

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School, Korea. bhahn@chonnam.ac.kr
  • 2Department of Cardiology, Chonnam National University Medical School, Korea.

Abstract

Addisonian crisis, also commonly referred to as adrenal crisis, occurs when the cortisol produced by the adrenal gland is insufficient to meet the body's needs. Pituitary apoplexy usually occurs as hemorrhagic and ischemic necrosis in the presence of a pre-existing pituitary adenoma, and is a rare sequela of cardiovascular surgery. Most pituitary apoplexy that happens in cardiovascular surgery has been known to be related to harmful effects of the cardiopulmonary bypass. The case presented herein illustrates occult pituitary apoplexy that occurred after off-pump coronary artery bypass grafting. In this patient, the initial signs of addisonian crisis was similar to those of septic shock, and were overlooked. However, once recognized, they were reduced dramatically with standard stress-dose cortisone.

Keyword

Adrenal gland hypofunction; Off-pump; Coronary artery bypass; Pituitary gland

MeSH Terms

Adrenal Glands
Adrenal Insufficiency
Cardiopulmonary Bypass
Coronary Artery Bypass
Coronary Artery Bypass, Off-Pump*
Cortisone
Humans
Hydrocortisone
Necrosis
Pituitary Apoplexy
Pituitary Gland
Pituitary Neoplasms
Shock, Septic
Transplants
Cortisone
Hydrocortisone
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