ramipril and Addison-Disease

Reversible left ventricular dysfunction, also termed Takotsubo cardiomyopathy, is rarely reported in Addison's disease after initiation of hormone replacement therapy. The pathogenesis of this cardiomyopathy is unknown.. Although we could not exclude coronary artery disease by coronary angiography, her clinical course and instrumental findings suggest Takotsubo cardiomyopathy of the apical type. Fludrocortisone overdosage and increased myocardial vulnerability due to cortisol deficiency might be pathogenetic factors, whereas myocarditis is unlikely. When hormone replacement in patients with Addison's disease is initiated, cardiac function should be monitored by electrocardiogram and echocardiography.

Topics: Addison Disease; Adult; Anti-Inflammatory Agents; Antihypertensive Agents; Biomarkers; Bisoprolol; Dose-Response Relationship, Drug; Drug Overdose; Female; Fludrocortisone; Heart Failure; Humans; Ramipril; Takotsubo Cardiomyopathy; Treatment Outcome