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January 1, 2019International Journal of Cardiovascular and Thoracic SurgeryOpen Access

Refractory Hypotension post Coronary Artery Bypass Graft Unmasking Hypoaldosteronism: Case Report and Literature Review

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Why the study?

Disorders involving both the sympathetic nervous system and RAAS can co-occur, especially around CABG surgery, warranting description of this presentation and literature review.

Population

One 63-year-old male with triple vessel disease undergoing CABG

Design

Case report and literature review

Authors

CSCarla Sawan

Discussion

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Overview

May resolve refractory post-CABG hypotension from hyporeninemic hypoaldosteronism; hypothesis-generating and should not yet change practice.

Structured PICO

P
Population
1 patient, a 63-year-old male with a history of hypertension, hyperlipidemia, and triple vessel disease presenting for coronary artery bypass graft (CABG) surgery.
I
Intervention
Fludrocortisone 0.1 mg daily
O
Outcome
Hemodynamic improvement and resolution of symptoms (hypotension and bradycardia)

Fludrocortisone successfully treated refractory hypotension caused by hyporeninemic hypoaldosteronism secondary to autonomic dysfunction that was unmasked by CABG surgery.

Cite This Study

Carla Sawan (2019) studied this question.

synapsesocial.com/papers/6a7ca9e9b7ca9b673b7cd115https://doi.org/10.11648/j.ijcts.20190502.14
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Hyporeninemic Hypoaldosteronism in Diabetes Mellitus: Studies of the Autonomic Nervous System's Control of Renin Release1979 · 78 citations
  2. 2Association between cardiac autonomic nervous dysfunction and the severity of coronary lesions in patients with stable coronary artery disease2018 · 30 citations
  3. 3Changes in Heart Rate Variability after Coronary Artery Bypass Grafting and Clinical Importance of These Findings2015 · 42 citations
  4. 4Clinical Physiology of Acid-Base and Electrolyte Disorders1990 · 1,164 citations
  5. 5Big Renin and Biosynthetic Defect of Aldosterone in Diabetes Mellitus1976 · 103 citations