European heart journal. Case reports · 2025
Bidirectional ventricular tachycardia and cardiogenic shock caused by acute haemorrhagic necrosis of pheochromocytoma: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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López-Pena Alejandro Manuel, Abou Jokh-Casas Charigan, Armesto-Rivas Jorge, De Urbano-Seara Gonzalo, González-Juanatey Carlos
Аннотация
BACKGROUND: Pheochromocytoma is associated with serious cardiovascular complications resulting from the effect of catecholamines, such as ventricular arrhythmias, cardiomyopathy with left ventricular dysfunction, and cardiogenic shock. Bidirectional ventricular tachycardia (BVT) is a rare but potentially fatal form of polymorphic tachycardia associated with elevated sympathetic tone.
CASE SUMMARY: A 27-year-old Caucasian woman was admitted to the intensive care unit with cardiogenic shock. The electrocardiogram showed BVT, and the transthoracic echocardiogram showed a dilated left ventricle with severe systolic dysfunction. Computed tomography revealed an adrenal mass with haemorrhage, which was confirmed by abdominal magnetic resonance imaging. The patient underwent a laparoscopic right adrenalectomy after pre-operative preparation with alpha-beta blockade, with subsequent histopathological confirmation of the diagnosis.
DISCUSSION: The acute presentation of haemorrhagic necrosis of a pheochromocytoma is a rare and potentially lethal condition. Its diagnosis can be challenging, especially in cases with atypical manifestations. However, the presence of BVT might serve as a crucial guide for its identification. Early recognition of this condition is essential, as it significantly impacts the patient's prognosis.
CASE SUMMARY: A 27-year-old Caucasian woman was admitted to the intensive care unit with cardiogenic shock. The electrocardiogram showed BVT, and the transthoracic echocardiogram showed a dilated left ventricle with severe systolic dysfunction. Computed tomography revealed an adrenal mass with haemorrhage, which was confirmed by abdominal magnetic resonance imaging. The patient underwent a laparoscopic right adrenalectomy after pre-operative preparation with alpha-beta blockade, with subsequent histopathological confirmation of the diagnosis.
DISCUSSION: The acute presentation of haemorrhagic necrosis of a pheochromocytoma is a rare and potentially lethal condition. Its diagnosis can be challenging, especially in cases with atypical manifestations. However, the presence of BVT might serve as a crucial guide for its identification. Early recognition of this condition is essential, as it significantly impacts the patient's prognosis.