A Preventable Ordeal: Life-Threatening Adrenal Insufficiency Masquerading as Refractory Shock Leading to Unnecessary Reoperations in an Infant with Noonan Syndrome
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We report a case of life-threatening secondary adrenal insufficiency masquerading as refractory vasoplegic shock after cardiac surgery, which led to a diagnostic cascade of unnecessary reoperations. This case highlights a critical diagnostic blind spot. Refractory postoperative hypotension with preserved perfusion markers should trigger immediate consideration of secondary adrenal insufficiency. Empiric glucocorticoid therapy can be diagnostic, life-saving, and prevent iatrogenic harm from unnecessary invasive procedures.
