Document Detail


Imipramine-provoked paradoxical pheochromocytoma crisis: a case of cardiogenic shock.
MedLine Citation:
PMID:  8161395     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The dramatic presentation of pheochromocytoma in crisis is uncommon and is classically associated with a state of hemodynamic and sympathetic hyperactivity. The case of a 35-year-old man with an occult pheochromocytoma presenting with hypotension and cardiogenic shock shortly after beginning imipramine therapy is presented. Retrospectively, there was a history of emergency department, inpatient, and outpatient evaluation of symptoms likely to be related to an occult pheochromocytoma. He presented with hypotension refractory to fluids and inotropes and in severe respiratory distress. The early differential diagnosis was extensive including acute myocardial infarction, pneumonia with sepsis, and toxic ingestion. Shortly after admission the patient's occult pheochromocytoma was discovered and subsequently specific therapy was initiated. The patient's symptoms resolved after surgical resection of the tumor, and he was ultimately discharged without signs of congestive heart failure. The clinical pathophysiology of cardiomyopathy secondary to pheochromocytoma, and possible mechanisms of pharmacological interactions with tricyclic antidepressants are discussed.
Authors:
K L Ferguson
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  12     ISSN:  0735-6757     ISO Abbreviation:  Am J Emerg Med     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-05-20     Completed Date:  1994-05-20     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  190-2     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Michigan Medical Center, Ann Arbor.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Neoplasms / complications*,  diagnosis,  surgery
Adult
Cardiomyopathy, Dilated / etiology*,  physiopathology
Diagnosis, Differential
Emergency Service, Hospital
Headache / complications*,  drug therapy*
Humans
Hypotension / etiology*,  physiopathology
Imipramine / adverse effects*
Male
Pheochromocytoma / complications*,  diagnosis,  surgery
Retrospective Studies
Shock, Cardiogenic / etiology*,  physiopathology
Chemical
Reg. No./Substance:
50-49-7/Imipramine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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