Journal of Korean Endocrine Society 2004;19(2):175-180.
Published online April 1, 2004.
Electrocardiographic Changes after Hormone Replacement Treatment in Patients with Sheehan's Syndrome.
Kyoung Hee Kweon, Chang Hun Lee, Byoung Hyun Park, Chung Gu Cho
Department of Internal Medicine, Wonkwang University School of medicine, Iksan, Korea.
Electrocardiographic abnormalities were studied to find if they were reversible during adequate hormonal treatment and to investigate regional inhomogenicity of ventricular repolarization in patients with Sheehan's syndrome. METHODS: Eleven women with Sheehan syndrome, who treated with prednisolone and levothyroxine, were the subjects of this study. Before and after hormonal replacement, the plasma thyroxine, cortisol and resting standard EKG were checked RESULTS: The most frequent electrocardiographic finding was inversion or flattening of the T waves, which occurred in 10 patients, with QT prolongation (7 patients), ST depression (2 patients) being the other findings. After prednisolone and levothyroxine replacement, the T wave abnormalities were normalized in 8 patients (80%) and the ST depression all patients. The QT (437 27 msec vs. 379 29 msec, p<0.05) and QTc intervals (478 80 msec vs 403 73 msec, p<0.005) were shortened by hormone replacement. CONCLUSION: High incidences of electrocardiographic abnormalities, including T wave inversion or flattening, QT prolongation and ST depression, were noted in patients with Sheehan's syndrome. The majority of these abnormalities recovered due to hormone replacement. The QT and QTc interval values were significantly shortened after treatment. Therefore, the regional inhomogenicity of ventricular repolarization may recover with hormone replacement
Key Words: Sheehan's syndrome, QT prolongation, Electrocardiogram

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