Pheochromocytoma Crisis Triggered by Extra-Corporal Membrane Oxygenation Explantation
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2016, Vol 11, Issue 7
Abstract
Context: We report a 59 year old Chinese woman in pheochromocytoma multisystem crisis and was initially stabilised with ECMO; subsequently she manifested rapid cyclical fluctuation of blood pressure precipitated by explantation of ECMO. Case Description: Madam L presented with chest pain and giddiness. She developed cardiogenic shock refractory to double inotropes and intra-aortic balloon pump (IABP); but responded to Extra-Corporal Membrane Oxygenation (ECMO). Subsequently rapid cyclical blood pressure fluctuations from 230 mmHg to 50mmHg systolic occurred after explantation of ECMO. Biochemically urine metanephrines and normetanephrines were more than seven times above upper limit of normal. Imaging confirmed the presence of right adrenal mass likely pheochromocytoma. She was started on alpha blockade and underwent an uneventful laparotomy with removal of a 10 cm adrenal mass. Histology confirmed a large cystic pheochromocytoma with haemorrhagic components. Conclusions: Pheochromocytoma crisis should be suspected in cases of unexplained shock or Takutsubo cardiomyopathy; early recognition and ECMO support can be life-saving. In addition, ECMO explantation can trigger rapid cyclical blood pressure fluctuations and should be closely monitored for.
Authors and Affiliations
Zhang Meifen, Sueziani Binte Zainudin, Chng Chiaw Ling
Keywords
Related Articles
- EP ID EP340302
- DOI 10.9734/BJMMR/2016/21709
- Views 62
- Downloads 0
Interconception Health Services for Women at High Risk for Adverse Pregnancy Outcomes: A Descriptive Study
Aims: To describe and present results of preconception care services aimed at underserved women who have experienced an adverse birth outcome. Study Design: Retrospective descriptive study. Place and Duration of Study: S...
Colorectal Carcinogenesis from Gut-associated Lymphoid Tissue Clinical and Experimental Documentation
Aims: The conventional (tubular or villous) adenoma-carcinoma pathway and the serrated adenoma-carcinoma pathway evolve in the vast colorectal mucosa built with crypts lined with mucus producing goblet cells and columnar...
Pattern and Trends of Respiratory Disease Admissions at the Emergency Paediatrics Unit of Jos University Teaching Hospital – A Four Year Review
Aims: Respiratory diseases contributes substantially to the number of Paediatric admissions and deaths especially in low income countries. Understanding the trends will help in health planning and resource distribution....
An Outpatient-based Survey on the Recognition of Locomotive Syndrome in Japan: The Results of three Years of Surveys
Background: In 2007, the Japanese Orthopaedic Association (JOA) proposed the term locomotive syndrome (LS) and the Japan Locomo Challenge Promotion Conference (JLCPC) began to carry out continuous campaigns to increase t...
Cementoblastoma in the Maxilla: An Unusual Case Report
Cementoblastoma is characterized by the formation of cementum-like tissue attached to the root of a tooth. It is a benign neoplasm with odontogenic mesenchymal origin, and is considered the only true neoplasm of cemental...