Adrenal tumors 3 Infections Pituitary tumors 4 Glucocorticoids prescribed by healthcare workers
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Pituitary tumors 4 Glucocorticoids prescribed by healthcare workers
Mr. M.S., an overweight, 55 yo white male presents to your clinic with chest pains. He has a history of hypertension, alcohol use and does not restrict his diet. He is currently taking nitroglycerin tablets as needed for angina. This pain is worse and is not controlled by nitroglycerin. The pain is radiating down his left arm. The pain in the chest feels like pressure or heartburn. You hear inspiratory rales, consistent with pulmonary edema. His blood pressure is 100/75. He begins to have difficulty breathing, especially when lying down. EKG and serum enzymes suggest a left ventricular wall myocardial infarction. Cardiac catheterization reveals a pulmonary wedge pressure of 30 mm Hg (normal, 5 mm Hg) and two-dimensional echocardiography measured an ejection fraction of 0.35 (normal, 0.55). In the Coronary ICU, he was treated with thrombolytic agents (tPA), digitalis (a positive inotropic agent) and furosemide (Lasix, a loop diuretic)
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