title: Long-standing undiagnosed sheehan syndrome presenting as polymorphic and monomorphic ventricular tachycardia: a case series of 2 patients.
abstract: OBJECTIVE
  To describe 2 cases of Sheehan syndrome presenting with ventricular tachycardia.
  
  
  METHODS
  In this case series, we present 2 cases of Sheehan syndrome presenting with ventricular tachycardia, which is an extremely rare complication of Sheehan syndrome. We review the literature for cases of panhypopituitarism presenting with ventricular tachycardia and also review the pathophysiologic mechanisms underlying development of ventricular tachycardia in these patients.
  
  
  RESULTS
  Two female patients presented with ventricular tachycardia. One patient had monomorphic and the other had polymorphic ventricular tachycardia. On further workup, both patients were found to have panhypopituitarism. Due to past history of postpartum hemorrhage, both patients were suspected of having Sheehan syndrome as the cause of panhypopituitarism. Electrocardiogram revealed prolonged QT interval. Both patients were started on hormone replacement therapy. Both patients responded well initially and were discharged home. One of the patients is alive and healthy at the time of this report. However, the other patient was readmitted with seizures a few days after discharge and unfortunately died of sudden cardiac arrest.
  
  
  CONCLUSIONS
  Untreated cases of Sheehan syndrome can present with fatal ventricular tachycardia. Hormone replacement in these patients can treat and prevent fatal arrhythmias.
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Muhammad Qamar
authors.initials: MQ
authors.lastname: Masood
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Syed Ahsan
authors.initials: SA
authors.lastname: Ali
mesh_terms: D004562:Electrocardiography; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007018:Hypopituitarism; D017180:Tachycardia, Ventricular