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A Case of Acute Decompensated Heart Failure Caused by Constrictive Pericarditis Complication of Addison's Disease Takuya Goto 1,2 , Kosuke Takehara 1 , Koji Tanaka 1 , Norio Kanatsuna 1 , Katsuya Kitano 1 , Osamu Nakajima 1 , Sadaki Sakane 1 , Keizou Furukawa 1 , Masahiro Daimon 3 , Takahiro Katsumata 3 1Department of Internal Medicine, Hirakata Municipal Hospital 2Department of Emergency Medicine, Osaka Mishima Emergency and Critical Care Center 3Department of Cardiovascular Surgery, Osaka Medical College Keyword: 収縮性心膜炎 , アジソン病 , うっ血性心不全 , レニン・アンジオテンシン・アルドステロン系 , constrictive pericarditis , Addison's disease , congestive heart failure , renin-angiotensin-aldosterone system pp.1317-1321
Published Date 2009/12/15
DOI https://doi.org/10.11477/mf.1404101395
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 A 76-year-old female was admitted to our hospital with the chief complaint of shortness of breath and bilateral swelling of the lower extremities. At first we made a diagnosis of heart failure with normal left ventricular ejection fraction that is, diastolic dysfunction, but chest radiogram revealed calcification of the pericardium and computed tomography revealed that the right atrium and ventricle was covered with thickened and calcified pericardium, "armored heart". Catheterization of the right side of the heart demonstrated a dip and plateau pattern of the right and left ventricular pressure wave form and equalization of the right and left diastolic pressure. Constrictive pericarditis was diagnosed. Systemic pigmentation and electrolytic disorder during the treatment of acute decompensated heart failure made us suspect of the complication of Addison's disease. Rapid ACTH stimulation test confirmed the diagnosis of Addison's disease. In developed countries, because tuberculosis is not a common cause of constrictive pericarditis and Addison's disease, no cause had been identified. Administration of rennin-angiotensin-aldosterone inhibitors for acute decompensated heart failure led to electrolytic disorder.


Copyright © 2009, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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