Shock Following Percutaneous Coronary Intervention as a Manifestation of Diabetes Insipidus: A Case Report
School of Medicine Students' Journal,
Vol. 1 No. 1 (2019),
10 December 2019
The shock syndrome following percutaneous coronary intervention (PCI) is a life-threatening complication, accompanied by poor outcomes. The most common causes are bleeding and severe left ventricular systolic dysfunction; albeit rare complications, they are still challenging. We herein report a 47-year-old man who suffered from complications following PCI, manifested as unexplained shock, which was resistant to conventional management.
Overestimating the role of the patient’s underlying disorder as the cause of the hypotension led to delay in diagnosis and treatment; however, obtaining a thorough familial history revealed diabetes insipidus (DI) as the most probable cause of the hypotension despite normal electrolyte levels at the time of admission. The patient dramatically responded to DI management.
Persistent hypotension or shock after PCI can result from an unusual or rare etiology. Meticulous history taking and attention to clinical findings are essential for an accurate diagnosis and timely treatment of this life-threatening condition.
- Shock syndrome
- Diabetes insipidus
- percutaneous coronary intervention
How to Cite
S. Valente, C. Lazzeri, S. Vecchio, C. Giglioli, M. Margheri, P. Bernardo, et al.Predictors of in-hospital mortality after percutaneous coronary intervention for cardiogenic shock.International journal of cardiology.2007;114(2):176-82.
Eng MH,Moses JW,Teirstein PS.Complications of Percutaneous Coronary Intervention. In: Topol EJ. Textbook of Interventional Cardiology.Elsevier. 6th edition. pp 357-371, 2012.
G. Dangas, I. Iakovou, E. Nikolsky, E. D. Aymong, G. S. Mintz, N. N. Kipshidze, et al.Contrast-induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variables.The American journal of cardiology.2005;95(1):13-19.
Ragosta M .Retroperitoneal bleeding.In:Cases in Interventional Cardiology. Elsevier –Saunders ,pp 135-8, 2011.
J. Bakker, P. Gris, M. Coffernils, R. J. Kahn and J. L. Vincent.Serial blood lactate levels can predict the development of multiple organ failure following septic shock.The American journal of surgery.1996;171(2):221-26.
M. H. Weil, J. Leavy and E. C. Rackow.Prognosis in shock.Anaesthesia.1986;41(1):80-2.
A. Meregalli, R. P. Oliveira and G. Friedman.Occult hypoperfusion is associated with increased mortality in hemodynamically stable, high-risk, surgical patients.Crit Care.2004;8(2):R60-5.
Ragosta M.Complications of cardiac catheterization .In:Cardiac Catheterization. Elsevier –Saunders ,pp 21-31,2010.
A. N. Makaryus and S. I. McFarlane.Diabetes insipidus: diagnosis and treatment of a complex disease.Cleveland Clinic journal of medicine.2006;73(1):65-71.
F. Rauch, C. Lenzner, P. Nürnberg, C. Frömmel and U. Vetter.A novel mutation in the coding region for neurophysin‐II is associated with autosomal dominant neurohypophyseal diabetes insipidus.Clinical endocrinology.1996;44(1):45-51.
D. R. Repaske, R. Medlej, E. K. Gültekin, M. Krishnamani, G. Halaby, J. W. Findling, et al.Heterogeneity in clinical manifestation of autosomal dominant neurohypophyseal diabetes insipidus caused by a mutation encoding Ala− 1→ Val in the signal peptide of the arginine vasopressin/neurophysin II/copeptin precursor.Journal of Clinical Endocrinology & Metabolism.1997;82(1):51-56.
- Abstract Viewed: 2321 times
- PDF Downloaded: 43 times