title: Catastrophic catecholamine-induced cardiomyopathy mimicking acute myocardial infarction, rescued by extracorporeal membrane oxygenation (ECMO) in pheochromocytoma.
abstract: Pheochromocytoma is a rare disorder and functioning tumor composed of chromaffin cells that secrete catecholamines. Patients with a pheochromocytoma 'crisis' have a high mortality in spite of aggressive therapy. We present a case with a severe acute catecholamine cardiomyopathy presenting ST segment elevation with cardiogenic shock after hemorrhage into a left suprarenal tumor. Intra-aortic balloon pump (IABP) support, combined with inotropic therapy, was performed. However, the patient deteriorated rapidly and was unresponsive to a full dose of inotropics and IABP. We decided to apply extracorporeal membrane oxygenation (ECMO) device for the patient. His clinical state began to improve 3 days after ECMO. After achieving hemodynamic stabilization, he underwent successful laparoscopic left adrenalectomy. He needed no further cardiac medication after discharge.
authors.affiliation: Department of Medicine, Division of Cardiology, Asan Medical Center, University of Ulsan, 388-1 Pungnap-dong, Songpa-gu, Seoul, Korea.
authors.forename: Il-Woo
authors.initials: IW
authors.lastname: Suh
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Jae-Joong
authors.initials: JJ
authors.lastname: Kim
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000311:Adrenal Glands / Q000473:pathology; D000328:Adult; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000209:etiology*; D002395:Catecholamines / Q000009:adverse effects*; D017023:Coronary Angiography / Q000379:methods; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis*; D010673:Pheochromocytoma / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D002395:Catecholamines