Pheochromocytoma presenting as life-threatening pulmonary edema

J. Kaye, S. Edlin, I. Thompson, Peter Leedman

    Research output: Contribution to journalArticle

    14 Citations (Scopus)

    Abstract

    Acute cardiogenic pulmonary edema as the first presentation of pheochromocytoma is uncommon and usually rapidly fatal. A 39-yr-old man presented in acute cardiogenic shock with global ventricular dysfunction that required high-dose iv inotrope support and an intraaortic balloon pump assist device. Abdominal imaging to exclude aortic dissection revealed a 6-cm right adrenal mass. Significant myocardial infarction (electrocardiographic changes and elevated cardiac enzymes) contributed to the cardiac decompensation. After withdrawal of inotrope support, 24-h urinary catecholamine levels revealed 2155 nmol/d (<125) of adrenaline and 7437 nmol/d (<560) of noradrenaline, confirming a pheochromocytoma. The tumor was successfully removed at laparotomy; however, the patient's course was complicated by a thromboembolic cerebrovascular accident with paraplegia. He recovered cardiac function almost completely within 3 wk of medical therapy alone. Although uncommon, this case highlights the need to consider pheochromocytoma early in the management of unexplained cardiogenic shock.
    Original languageEnglish
    Pages (from-to)203-204
    JournalEndocrine
    Volume15
    DOIs
    Publication statusPublished - 2001

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