Is it coronary heart disease or pituitary tumor?

79-year-old Grandpa Ma developed loss of appetite, fatigue, palpitations, shortness of breath, chest tightness and pain 4 months ago. An electrocardiogram revealed atrial premature beats and myocardial ischemia. He was diagnosed with coronary heart disease by the local hospital. However, after a long period of treatment, Grandpa Ma's symptoms did not show any significant improvement.

After being transferred to another hospital, Grandpa Ma had a blood biochemical test and found that Na+ was 123mmol/L and Cl- was 91.4mmol/L. He was treated with sodium salt supplementation and oral prednisone (2.5mg), which relieved his condition. However, once sodium salt was stopped, his condition recurred.

In addition to routine examinations, the experienced doctor also recommended that Grandpa Ma do a pituitary MRI. The results showed: pituitary macroadenoma (maximum diameter 24.2cm×16.2cm×19.9cm). FT410.85pmol/L, progesterone 0.02ng/ml, luteinizing hormone 0.70mlU/ml, neutrophil ratio 36.2%. Chest X-ray, thyroid and kidney ultrasound showed no abnormalities. The clinical diagnosis was pituitary adenoma and hyponatremia.

The doctor told Grandpa Ma’s family that pituitary tumors are complex and changeable, and difficult to identify, especially for non-secreting adenomas, which lack specific symptoms. Grandpa Ma is nearly 80 years old, his body functions are slowly declining, and his specific symptoms are not prominent, so the symptoms of the disease are misdiagnosed as other diseases by non-specialist doctors.

Pituitary tumors are common benign adenomas. When patients experience symptoms such as fatigue, weakness, mental depression, loss of appetite, drowsiness, hypoglycemia, and hyponatremia, the possibility of a tumor should be considered. Especially for middle-aged and elderly people, it is important to distinguish the symptoms of brain tumors from those of diseases such as coronary heart disease.