Catastrophic catecholamine-induced cardiomyopathy mimicking acute myocardial infarction, rescued by extracorporeal membrane oxygenation (ECMO) in pheochromocytoma.
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.
Suh
Il-Woo
IW
Department of Medicine, Division of Cardiology, Asan Medical Center, University of Ulsan, 388-1 Pungnap-dong, Songpa-gu, Seoul, Korea.
Lee
Cheol Whan
CW
Kim
Young-Hak
YH
Hong
Myeong-Ki
MK
Lee
Jae-Won
JW
Kim
Jae-Joong
JJ
Park
Seong-Wook
SW
Park
Seung-Jung
SJ
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
D002395:Catecholamines