SUN-364 Panhypopituitarism Induced Ventricular Tachycardia: Hormonal Relationship All Should Keep in Mind

Abstract Disclosure: K. Feng: None. S. Ozair: None. J. Perkins: None. Panhypopituitarism is the deficiency of all anterior pituitary hormones. Two of these hormones, thyroid-stimulating hormone (TSH) and adrenocorticotropic hormone (ACTH), play integral roles on the heart [1]. A 36-year-old female with history of craniopharyngioma status-post radiotherapy and radiosurgery, panhypopituitarism, and diabetes insipidus presented to the hospital with several days of weakness, shortness of breath, nausea and vomiting. At home, the patient was prescribed levothyroxine, calcitriol, hydrocortisone, and desmopressin. Initial lab findings were significant for sodium 125 mEq/L, calcium 7.4 mg/dL, magnesium 2.7 mg/dL, potassium 3.6 mEQ/L, TSH 0.060 UIU/mL with reflex T4 <0.04 ng/dL, and cortisol 1.8 mcg/dL.Cardiac monitoring demonstrated ventricular tachycardia (VT) with a prolonged QT interval of 456 ms. She was treated with IV levothyroxine, IV hydrocortisone, electrolyte replacement, and IV fluid resuscitation. TTE revealed normal heart function without concern for new ischemic changes. Cardiology was consulted and recommended continued correction of hormonal abnormalities and electrolytes. With continued correction of her abnormalities she became hemodynamically stable with no further episodes of VT. She was discharged with levothyroxine and hydrocortisone. Several weeks after discharge, her ECG demonstrated a corrected QT interval of 371 ms. Commonly, adrenal insufficiency causes fatigue, weight loss, abdominal pain, hypotension and hypoglycemia [2]. Hypothyroidism results in fatigue, weight gain, constipation, hair loss, cold intolerance, and sinus bradycardia. Additionally deficiency of these hormones contribute to electrolyte imbalances that result in QT interval prolongation leading to unstable cardiac electrical activity and VT. This patient had severe adrenal insufficiency and thyroid hormone deficiency, which caused the electrolyte imbalance leading to QT interval prolongation and VT. When evaluating patients with ventricular arrhythmias it is essential to not only measure electrolyte levels but also to measure hormone levels, such as TSH and ACTH. It is critical to consider underlying endocrine pathology when evaluating cardiac dysfunction and arrhythmias. Presentation: Sunday, July 13, 2025