title: Utility of alpha-blockade in a hypotensive pheochromocytoma patient with myocardial infarction.
abstract: OBJECTIVE
  The aim of this case study is to emphasize the importance of α-blockade in managing a rare complication of an untreated pheochromocytoma.
  
  
  METHODS
  A 41-year-old man with previous bilateral pheochromocytoma presented with chest pain. He was suffering from cardiac failure and persistent hypotension requiring an inotrope. Cardiac markers, an electrocardiogram and an echocardiogram confirmed acute myocardial infarct with poor ejection fraction and global hypokinesia. An (18)F-fluorodeoxyglucose PET/CT scan showed progressive left suprarenal and organ of Zuckerkandl pheochromocytomas. Blood pressure stabilisation proved challenging but was achieved by titrating an incremental dose of α-blocker against a tapering inotropic dose.
  
  
  CONCLUSIONS
  This case showed the efficacy of an α-blocker despite persistent hypotension in a patient with pheochromocytoma-induced cardiomyopathy.
authors.affiliation: Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia.
authors.forename: Norasyikin A
authors.initials: NA
authors.lastname: Wahab
authors.forename: Suehazlyn
authors.initials: S
authors.lastname: Zainudin
authors.forename: Aini
authors.initials: A
authors.lastname: AbAziz
authors.forename: Nor Azmi
authors.initials: NA
authors.lastname: Kamaruddin
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications; D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage*; D000328:Adult; D004452:Echocardiography; D006801:Humans; D007022:Hypotension / Q000150:complications; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D010220:Para-Aortic Bodies; D010673:Pheochromocytoma / Q000150:complications; D011224:Prazosin / Q000008:administration & dosage*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D011224:Prazosin