Myocardial infarction as a complication of pheochromocytoma in a pregnant woman

Hamada, Satoko; Hinokio, Kenji; Naka, Osamu; Higuchi, Kazuhiko; Takahashi, Hiroyuki; Sumitani, Haruo

doi:10.1016/s0301-2115(95)02542-1

Cited by 18 publications

(4 citation statements)

References 7 publications

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“…We have reported a case of a patient with a phaeochromocytoma who presented with signs and symptoms that mimicked those of an acute myocardial infarction (AMI). In fact, phaeochromocytoma can cause an AMI [1, 2, 4] and the diagnosis may therefore be delayed. Cohen et al.…”

Section: Discussionmentioning

confidence: 99%

Phaeochromocytoma crisis – a rare indication for extracorporeal membrane oxygenation

Chao

Yeh

Yen³

et al. 2007

Anaesthesia

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SummaryWe report on a case of phaeochromocytoma whose initial presentation mimicked an acute myocardial infarction. Veno-arterial extracorporeal membrane oxygenation was used for the management of refractory cardiogenic shock and massive lung oedema. Suspicion and diagnosis of a phaeochromocytoma were made due to its unique clinical presentation during extracorporeal membrane oxygenation. Stabilisation of the crisis and recovery of cardiopulmonary function were achieved using the support of extracorporeal membrane oxygenation. This case highlights the difficulty in the differential diagnosis of cardiogenic shock secondary to phaeochromocytoma and the important role of extracorporeal membrane oxygenation can have in the successful resuscitation and management of these patients.

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Section: Discussionmentioning

confidence: 99%

Phaeochromocytoma crisis – a rare indication for extracorporeal membrane oxygenation

Chao

Yeh

Yen³

et al. 2007

Anaesthesia

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“…The fact that the antenatal diagnosis of PHEO has increased since 1990 points to a greater awareness of this neoplasm in pregnancy . However, PHEO is correctly diagnosed during pregnancy in only about one‐third of affected patients .…”

Section: Discussionmentioning

confidence: 99%

“…As the adrenal glands are innervated by sympathetic nerves from T5 to T12, epidural sympathetic anesthesia across these levels would limit the increase in catecholamines. However, not only does general anesthesia increase adrenal function, but also the risks related to surgery and anesthesia are very high and may lead to acute hypertension, myocardial infarction, and severe heart failure , or to pulmonary edema . On the other hand, patients with highly norepinephrine and dopamine‐secreting PHEO are likely to suffer from persisting postoperative hypotension .…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Sudden Death Due to Hypotension during Cesarean Section in a Woman Suffering from Pheochromocytoma and Neurofibromatosis

Cecchi

Frati

Capri

et al. 2013

Journal of Forensic Sciences

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Sudden death following acute hypotension due to an undiagnosed pheochromocytoma (PHEO) is a rare event. Moreover, histopathology of the myocardium in such cases is rarely reported. We present a case of a woman who died during delivery. A 37-year-old parturient, who was 38 weeks pregnant, suffering from neurofibromatosis underwent a cesarean section following peridural anesthesia. Acute hypotension, acute intra-operative pulmonary edema and supraventricular paroxysmal tachyarrhythmia occurred during delivery, followed by death. The autopsy revealed the presence of a PHEO, confirmed immunohistochemically with chromogranin-A (CgA), CD20 antibody (L26), anti-Keratocan antibody (KER-1) and neuron-specific enolase (NSE), and a PHEO-induced cardiomyopathy. The physiopathology of both stress-induced cardiomyopathy and PHEO-induced cardiomyopathy, as well as the role of anesthesia in provoking the death, are discussed. The association of an undiagnosed PHEO with neurofibromatosis as the cause of sudden death in pregnancy is an obstetric urgency that raises forensic pathology issues.

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Akuter Myokardinfarkt bei der Phäochromozytom-Krise

Mauser¹,

Billmann²,

Fleischmann³

2001

Zeitschrift f�r Kardiologie

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A myocardial infarction is a rare complication of a pheochromocytoma. A pheochromo-cytoma crisis may occur spontaneously, during pregnancy, or may be induced by a local trauma of the tumor or by drugs. We present a case report of a 41-year-old woman without anamnestic episodes of hypertension or angina pectoris. During angiography of the mesenteric arteries for further diagnostics of a sonographically suspected liver tumor, she developed an acute pulmonary edema and a cardiogenic shock with the electro- and echocardiographic findings of a large anterolateral-apical-diaphragmal myocardial infarction. The immediate coronary angiography 90 min after the onset of the myocardial infarction showed normal coronary arteries with normal coronary blood flow of the arteries supplying myocardial areas with akinetic segments and those arteries supplying hyperkinetic segments. The blood catecholamine levels at this time were excessively elevated. The left ventricular function improved to almost normal within the next 4 weeks with the beginning of the improvement already before the abdominal tumor was surgically removed at day five. The histology documented a pheochromocytoma with acute necrosis. The early invasive findings support the hypothesis that a reversible spasm of several epicardial arteries and not a direct toxic effect of catecholamines could have been the cause of the small myocardial infarction and the observed large myocardial stunning.

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Myocardial infarction as a complication of pheochromocytoma in a pregnant woman

Cited by 18 publications

References 7 publications

Phaeochromocytoma crisis – a rare indication for extracorporeal membrane oxygenation

Phaeochromocytoma crisis – a rare indication for extracorporeal membrane oxygenation

A Rare Case of Sudden Death Due to Hypotension during Cesarean Section in a Woman Suffering from Pheochromocytoma and Neurofibromatosis

Akuter Myokardinfarkt bei der Phäochromozytom-Krise

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