Key result
Laparoscopic adrenalectomy restores BP and cardiac function in a pheochromocytoma patient presenting with Takotsubo cardiomyopathy.
Case Report (n=1)
Pheochromocytoma can present as Takotsubo cardiomyopathy during anesthesia induction, which is reversible following tumor resection.
May support pheochromocytoma evaluation in select Takotsubo cases; hypothesis-generating from single report, needs prospective validation.
A hypertensive crisis, with an acute heart failure and pulmonary oedema had complicated anesthesia induction, during an elective surgery was done to an elderly aged patient. This patient had hypertension, with a very controlled BP on Irbesartan (angiotensin receptor blocker), and a normal cardiac function before admission. The operation was aborted, and the patient was resuscitated in the theatre and the ICU. Investigations showed cardiomegaly on CXR, with abnormal size and function of the Lt Ventricle on echocardiograph, as well as high levels of serum troponin, and very high values of serum catecholamine's metabolites (metanephrines and normetanephrines). A high suspicion of pheochromacytoma was raised, and this was confirmed later by the presence of a large RT adrenal mass on abdominal CT scan and MIBG scan. After 3 weeks of supportive treatment in the ICU, with continuous monitoring of the very labile BP, the patient underwent a laparoscopic adrenalectomy. Postoperatively, the patient's BP and cardiac function were restored
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YR et al. (2016) conducted a case report in Pheochromocytoma presenting as Takotsubo Cardiomyopathy (n=1). Laparoscopic adrenalectomy was evaluated on Restoration of blood pressure and cardiac function. Laparoscopic adrenalectomy successfully restored blood pressure and cardiac function in an elderly patient with pheochromocytoma presenting as Takotsubo cardiomyopathy.
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