Pheochromocytoma in a Postpartum Patient With Cardiogenic Shock From Epicardial Vasospasm Necessitating Mechanical Circulatory Support
A 25-year-old woman presented with pheochromocytoma crisis and cardiogenic shock. Her ejection fraction was severely reduced at 10%, and she needed venoarterial extracorporeal membrane oxygenation (VA-ECMO) for hemodynamic support. Coronary angiography demonstrated diffuse coronary vasospasm as the...
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| Format: | Article |
| Language: | English |
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American College of Physicians
2025-01-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0464 |
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| author | Justin Brilliant Sarah Leventhal Mark Vesely Brian Barr Manjula Ananthram |
| author_facet | Justin Brilliant Sarah Leventhal Mark Vesely Brian Barr Manjula Ananthram |
| author_sort | Justin Brilliant |
| collection | DOAJ |
| description | A 25-year-old woman presented with pheochromocytoma crisis and cardiogenic shock. Her ejection fraction was severely reduced at 10%, and she needed venoarterial extracorporeal membrane oxygenation (VA-ECMO) for hemodynamic support. Coronary angiography demonstrated diffuse coronary vasospasm as the underlying mechanism for her cardiogenic shock. Her ejection fraction improved with nondihydropyridine calcium channel blockers for treatment of epicardial coronary vasospasm. Her adrenal crisis was treated with sequential use of alpha-blockers followed by beta-blockers after resolution of cardiogenic shock; a right adrenalectomy was then performed before discharge. This case highlights the importance of prompt diagnosis and treatment of a pheochromocytoma complicated by cardiogenic shock when mechanical circulatory support is essential. |
| format | Article |
| id | doaj-art-0c6399a3d0324540840be9e4badd1fe8 |
| institution | DOAJ |
| issn | 2767-7664 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-0c6399a3d0324540840be9e4badd1fe82025-08-20T03:18:48ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642025-01-014110.7326/aimcc.2024.0464Pheochromocytoma in a Postpartum Patient With Cardiogenic Shock From Epicardial Vasospasm Necessitating Mechanical Circulatory SupportJustin Brilliant0Sarah Leventhal1Mark Vesely2Brian Barr3Manjula Ananthram41University of Maryland School of Medicine, Department of Medicine, Division of Cardiovascular Medicine, Baltimore, Maryland1University of Maryland School of Medicine, Department of Medicine, Division of Cardiovascular Medicine, Baltimore, Maryland1University of Maryland School of Medicine, Department of Medicine, Division of Cardiovascular Medicine, Baltimore, Maryland1University of Maryland School of Medicine, Department of Medicine, Division of Cardiovascular Medicine, Baltimore, Maryland1University of Maryland School of Medicine, Department of Medicine, Division of Cardiovascular Medicine, Baltimore, MarylandA 25-year-old woman presented with pheochromocytoma crisis and cardiogenic shock. Her ejection fraction was severely reduced at 10%, and she needed venoarterial extracorporeal membrane oxygenation (VA-ECMO) for hemodynamic support. Coronary angiography demonstrated diffuse coronary vasospasm as the underlying mechanism for her cardiogenic shock. Her ejection fraction improved with nondihydropyridine calcium channel blockers for treatment of epicardial coronary vasospasm. Her adrenal crisis was treated with sequential use of alpha-blockers followed by beta-blockers after resolution of cardiogenic shock; a right adrenalectomy was then performed before discharge. This case highlights the importance of prompt diagnosis and treatment of a pheochromocytoma complicated by cardiogenic shock when mechanical circulatory support is essential.https://www.acpjournals.org/doi/10.7326/aimcc.2024.0464 |
| spellingShingle | Justin Brilliant Sarah Leventhal Mark Vesely Brian Barr Manjula Ananthram Pheochromocytoma in a Postpartum Patient With Cardiogenic Shock From Epicardial Vasospasm Necessitating Mechanical Circulatory Support Annals of Internal Medicine: Clinical Cases |
| title | Pheochromocytoma in a Postpartum Patient With Cardiogenic Shock From Epicardial Vasospasm Necessitating Mechanical Circulatory Support |
| title_full | Pheochromocytoma in a Postpartum Patient With Cardiogenic Shock From Epicardial Vasospasm Necessitating Mechanical Circulatory Support |
| title_fullStr | Pheochromocytoma in a Postpartum Patient With Cardiogenic Shock From Epicardial Vasospasm Necessitating Mechanical Circulatory Support |
| title_full_unstemmed | Pheochromocytoma in a Postpartum Patient With Cardiogenic Shock From Epicardial Vasospasm Necessitating Mechanical Circulatory Support |
| title_short | Pheochromocytoma in a Postpartum Patient With Cardiogenic Shock From Epicardial Vasospasm Necessitating Mechanical Circulatory Support |
| title_sort | pheochromocytoma in a postpartum patient with cardiogenic shock from epicardial vasospasm necessitating mechanical circulatory support |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0464 |
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