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Review
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Korean J Med. 2006;71(1):282-282.
- Catastrophic catecholamine-induced cardiomyopathy mimicking acute myocardial infarction, rescued by ECMO in pheochromocytoma
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- Catastrophic catecholamine-induced cardiomyopathy mimicking acute myocardial infarction, rescued by ECMO in pheochromocytoma
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1Department of Internal Medicine, Hanyang University College of Medicine, Seoul; 2Department of Life Science, Postech Biotech Center, Pohang University of Science and Technology, Pohang, Korea
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- Abstract
- Pheochromocytoma is a rare disorder and functioning tumor composed of chromaffin cell that secrete catecholamines, affecting
one in a million people per year. Eighty-five percent are found in the medullae of the adrenal glands, but they may also occur
in the extra-adrenal, paraganglia. The most common manifestations are paroxysmal or sustained hypertension, with symptoms
of adrenergic stimulation, such as palpitations, headache, sweating and tremor. A number of patients remain asymptomatic. Less
frequent cardiovascular manifestations have been reported: acute pulmonary edema, myocardial infarction, cardiogenic shock,
acute myocarditis and dilated or hypertrophic cardiomyopathy., If patients present with a pheochromocytoma crisis , mortality
is very high, mostly from a cardiovascular origin, in spite of aggressive therapy. We present a case with a severe acute
catecholamine cardiomyopathy presenting ST segment elevation MI with cardiogenic shock after hemorrhage into a left
suprarenal tumor. Intra-aortic balloon pump (IABP) support, in combination with inotropic therapy, was performed. But the
patient deteriorated rapidly and was unresponsive to full dose of inotropics and IABP. We decided to apply ECMO
(extracorporeal membrane oxygenation) device for the patient. Clinical states began to improve 3 days after application of ECMO.
Once the patient had been hemodynamically stabilized, the tumor was successfully removed by laparoscopic left adrenalectomy.
He needed no further cardiac medication after discharge.
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