Document Detail


Pheochromocytoma presenting as life-threatening pulmonary edema.
MedLine Citation:
PMID:  11720247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Acute cardiogenic pulmonary edema as the first presentation of pheochromocytoma is uncommon and usually rapidly fatal. A 39-yr-old man presented in acute cardiogenic shock with global ventricular dysfunction that required high-dose iv inotrope support and an intraaortic balloon pump assist device. Abdominal imaging to exclude aortic dissection revealed a 6-cm right adrenal mass. Significant myocardial infarction (electrocardiographic changes and elevated cardiac enzymes) contributed to the cardiac decompensation. After withdrawal of inotrope support, 24-h urinary catecholamine levels revealed 2,155 nmol/d (<125) of adrenaline and 7,437 nmol/d (<560) of noradrenaline, confirming a pheochromocytoma. The tumor was successfully removed at laparotomy; however, the patient's course was complicated by a thromboembolic cerebrovascular accident with paraplegia. He recovered cardiac function almost completely within 3 wk of medical therapy alone. Although uncommon, this case highlights the need to consider pheochromocytoma early in the management of unexplained cardiogenic shock.
Authors:
J Kaye; S Edlin; I Thompson; P J Leedma
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Endocrine     Volume:  15     ISSN:  1355-008X     ISO Abbreviation:  Endocrine     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-11-26     Completed Date:  2002-04-04     Revised Date:  2010-06-24    
Medline Journal Info:
Nlm Unique ID:  9434444     Medline TA:  Endocrine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  203-4     Citation Subset:  IM    
Affiliation:
Department of Endocrinology and Diabetes, Royal Perth Hospital, Western Australia, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Neoplasms / complications,  diagnosis*,  surgery
Adult
Electrocardiography
Epinephrine / urine
Humans
Male
Myocardial Infarction / diagnosis,  etiology
Norepinephrine / urine
Paraplegia / complications
Pheochromocytoma / complications,  diagnosis*,  surgery
Pulmonary Edema / etiology*
Shock, Cardiogenic / etiology*
Stroke / complications
Thromboembolism / complications
Chemical
Reg. No./Substance:
51-41-2/Norepinephrine; 51-43-4/Epinephrine

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


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