Key result
Hormone replacement normalizes QTc and improves LVEF by ~10 points in hypopituitarism-induced long QT syndrome.
Why the study?
Acquired long QT syndrome caused by hypopituitarism and transient ST-segment elevation had not been reported in cardiac arrest patients.
Case Report (n=1)
No
Hypopituitarism is a rare, reversible cause of life-threatening acquired long QT syndrome and cardiac arrest that responds to hormone replacement therapy, while post-shock transient ST-segment elevation should be differentiated from acute myocardial infarction.
Answers are grounded in this paper and cite their sources.
Supports consideration of hormone replacement in hypopituitarism-associated long QT; leaves open broader applicability pending controlled studies.
Acquired long QT syndrome caused by hypopituitarism and transient ST-segment elevation has not been reported in cardiac arrest patients. We report a case of extremely dangerous acquired long QT syndrome and transient ST-segment elevation. A 44-year-old Chinese woman with renal failure experienced sudden cardiac arrest in the haemodialysis room. Subsequent electrocardiogram showed QT prolongation and transient ST-segment elevation. This patient's medical history, subsequent laboratory results and pituitary magnetic resonance imaging suggested hypopituitarism. Transient ST-segment elevation on the electrocardiogram was considered to be caused by repeated direct current shocks. The patient was diagnosed with acquired long QT syndrome and was not taking any antiarrhythmic drugs. Her corrected QT interval normalized after hormone replacement therapy. This case highlights the importance of the awareness of hypopituitarism; early identification and intervention can prevent the occurrence of this life-threatening arrhythmia. ST-segment elevation is not always due to acute myocardial infarction, and a variety of other causes, especially electrical cardioversion, should be considered.
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Zhang et al. (2023) conducted a case report in Acquired long QT syndrome and transient ST-segment elevation caused by hypopituitarism and repeated direct current shocks in a patient with renal failure (n=1). Hormone replacement therapy and direct current defibrillation/cardioversion was evaluated on Normalization of corrected QT interval (QTc) and left ventricular ejection fraction (EF). Hormone replacement therapy without antiarrhythmic drugs normalized the corrected QT interval and increased left ventricular ejection fraction from 45% to 55% at 1 month in a patient with hypopituitarism-induced acquired long QT syndrome.
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