An uncommon cause of acute pulmonary edema

Nepal, Santosh; Giri, Smith; Bhusal, Mohan; Siwakoti, Krishmita; Pathak, Ranjan

doi:10.1097/01.jaa.0000490945.35987.83

Cited by 4 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because of the extreme similarities between two reported pheochromocytoma‐induced TS cases, one case which was reported later was excluded . In total, 156 cases reports (107 cases with PPGL‐induced TS, 42 cases epinephrine‐induced TS, and 7 cases norepinephrine‐induced TS) constitute the patient cohort for the meta‐analysis. Among the cases included were two non‐English case reports (one case in Swedish and one in German) where enough information could be obtained.…”

Section: Resultsmentioning

confidence: 99%

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Y‐Hassan

Falhammar

2020

Clinical Cardiology

View full text Add to dashboard Cite

Innumerable physical stress factors including externally administered catecholamines, and pheochromocytomas and paragangliomas (PPGLs) have been reported to trigger Takotsubo syndrome (TS). A systematic search of PubMed/MEDLINE identified 156 patients with catecholamine-induced TS up to December 2017. Data were compared within the catecholamine-induced TS cohort, but some comparisons were also done to a previously published large all-TS cohort (n = 1750). The mean age was 46.4 ± 16.4 years (72.3% women). The clinical presentation was dramatic with high complication rates in (68.2%, n = 103; multiple complications 34.6%, n = 54). The most common TS ballooning pattern was apical or mid-apical (45.2%, n = 69), followed by basal pattern (28.8%, n = 45), global pattern (16.0%, n = 25), midventricular (8.3%, n = 13), focal (0.6%, n = 1), and unidentified pattern (1.9%, n = 3).There was an increase in the prevalence of apical sparing ballooning pattern compared to all-TS population (37.7% vs 18.3%, P < .00001). Higher complication rates were observed in TS with global ballooning pattern compared to apical ballooning pattern (23/25, 92% vs 38/65, 58.5%; P = .0022). Higher complication rates were observed in patients with age < 50 years than patients >50 years (73/92, 79.3% vs 29/56, 51.8%, P = 0.0009). Recurrence occurred exclusively in patients with PPGLinduced TS (18/107 patients, 16.8%). PPGL-induced TS was characterized by more global ballooning's pattern (22/104, 21.2% vs 3/49, 6.1%, P = 0.02), and lower left ventricular ejection fraction (25.54 ± 11.3 vs 31.82 ± 9.93, P = 0.0072) compared to exogenous catecholamine-induced TS. In conclusion, catecholamine-induced TS was characterized by a dramatic clinical presentation with extensive left ventricular dysfunction, and high complication rate. K E Y W O R D S broken heart syndrome, epinephrine, myocardial stunning, norepinephrine, paraganglioma, pheochromocytoma, Takotsubo

show abstract

Section: Resultsmentioning

confidence: 99%

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Y‐Hassan

Falhammar

2020

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…PHEO patients could also present with symptoms and signs of pulmonary edema and/or hypertensive crisis, and rarely with refractory cardiogenic shock requiring mechanical circulatory support [51,71]. Acute onset of dyspnea due to pulmonary edema has been described as the initial presentation of PHEO [72,73]. Pulmonary edema is believed to be caused by decompensation in the setting of CMP and severely increased peripheral vascular resistance [72].…”

Section: Acute Pulmonary Edemamentioning

confidence: 99%

“…Pulmonary edema is believed to be caused by decompensation in the setting of CMP and severely increased peripheral vascular resistance [72]. Moreover, patients rarely presented with non-cardiogenic pulmonary edema due to catecholamine-induced transient elevation in pulmonary capillary pressure, and permeability [73,74] increased pulmonary neutrophil accumulation [73], increased hydrostatic pressure due to overfilling or constriction of the pulmonary veins even in the absence of overt left ventricular dysfunction.…”

Section: Acute Pulmonary Edemamentioning

confidence: 99%

Catecholamine-Induced Cardiomyopathy in Pheochromocytoma: How to Manage a Rare Complication in a Rare Disease?

et al. 2018

View full text Add to dashboard Cite

Pheochromocytomas and paragangliomas (PHEOs) are rare neuroendocrine tumors. Clinical manifestations include different cardiovascular signs and symptoms, which are related to excessive secretion of catecholamines. Catecholamine-induced cardiomyopathy in PHEO (CICMPP) is a rare but dreaded complication of PHEO. Once patient is diagnosed with this condition, the prognosis is worse and a surgical risk is much higher than expected. This article focuses on how catecholamines affect the heart and the pathophysiologic mechanism of CICMPP. The cardiovascular responses to catecholamine depend mostly on which catecholamine is released as well as the amount of catecholamine that is released. The acute release of norepinephrine and epinephrine from PHEO increases heart rate, systemic vascular resistance, myocardial contractility, and reduces venous compliance. The excessive adrenergic stimulation by catecholamine results in severe vasoconstriction and coronary vasospasm, myocardial ischemia, and subsequently damage, and necrosis. Chronically elevated catecholamine levels lead to significant desensitization of cardiac β-adrenoceptors. The increased levels of the enzyme β-adrenoceptors kinase (βARK) in the heart seems to mediate these biochemical and physiological changes that are consistently correlated with attenuated responsiveness to catecholamine stimulation. Through these mechanisms different types of cardiomyopathy (CMP) can be formed. This review discusses extensively the 3 types of cardiomyopathies that can be present in a PHEO patient. It also provides the clinical presentation and diagnostic and therapeutic algorithm in managing patients with CICMPP.

show abstract

“…This can range from hypertensive crises to rapidly progressive circulatory and multi-organ failure. Severe cardiorespiratory disease with acute pulmonary edema can also occur as a first presentation [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Acute Pulmonary Edema as a Cardiovascular Manifestation of Pheochromocytoma

Ng¹,

Yu²,

Rajkanna³

2023

Cureus

View full text Add to dashboard Cite

Pheochromocytoma most commonly presents with the triad of paroxysms of headache, palpitations, and diaphoresis. Pheochromocytoma crisis, caused by a supra-physiological surge of catecholamine release, is an endocrine emergency that can present with various clinical manifestations. Acute pulmonary edema is one of the manifestations of pheochromocytoma crisis and can be either cardiogenic or non-cardiogenic. Here, we report cases of acute pulmonary edema of each type, related to pheochromocytoma crisis, which were presented to our district general hospital in 2020.

show abstract

An uncommon cause of acute pulmonary edema

Cited by 4 publications

References 16 publications

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Catecholamine-Induced Cardiomyopathy in Pheochromocytoma: How to Manage a Rare Complication in a Rare Disease?

Acute Pulmonary Edema as a Cardiovascular Manifestation of Pheochromocytoma

Contact Info

Product

Resources

About