A case of pheochromocytoma presenting with cardiopulmonary arrest

Publication date: Available online 29 August 2019Source: Journal of Cardiology CasesAuthor(s): Takashi Touma, Takafumi Miyara, Yoji TabaAbstractA 33-year-old woman complained of sudden chest pain and intense headache. She was unconscious and underwent defibrillation for ventricular fibrillation in the ambulance. In the emergency room, she was placed on an artificial respirator. Diffuse wall hypokinesis and decreased left ventricular ejection fraction (31%) were identified on transthoracic echocardiography, and an intra-aortic balloon pump was inserted to address the cardiogenic shock. A mass was identified in the right adrenal gland on abdominal ultrasonography. Since a pheochromocytoma was suspected, doxazosin and carvedilol were administered. Blood and urinary norepinephrine and dopamine levels were elevated, confirming the pheochromocytoma diagnosis, and right adrenalectomy was performed 23 days after the initial hospitalization. After surgery, the left ventricular wall motion and left ventricular ejection fraction had improved to 62% on echocardiography. Blood and urinary norepinephrine and dopamine levels also decreased to within the normal range. This case highlights that the patient returned to normalcy and recovered to a transient myocardial disorder or malignant arrhythmia after cardiopulmonary arrest due to early diagnosis of and accurate treatment for pheochromocytoma.<Learning objective: Pheochromocytomas secrete excessive levels of catecholamines that may cau...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research