Transient cardiogenic shock during a crisis of pheochromocytoma triggered by high-dose exogenous corticosteroids.
BMJ Case Rep
; 20152015 Feb 18.
Article
em En
| MEDLINE
| ID: mdl-25694646
ABSTRACT
We report a case of a 39-year-old woman who presented to the emergency department (ED) with symptoms of pharyngitis and fever. Diagnosed with streptococcal pharyngitis, she received antibiotics and dexamethasone, and was discharged. Within 24â
h she returned to the ED with signs and symptoms of an acute coronary syndrome; she was thus given ß-blockers. Her coronary angiogram was normal. She developed cardiogenic shock with an ejection fraction (EF) of 10% and apical ballooning on echocardiography. Her condition improved with optimal medical therapy. Subsequent testing weeks later confirmed the presence of a pheochromocytoma. Following prazosin and an adrenalectomy, all her antihypertensive medications were weaned and her EF normalised. We believe the high-dose exogenous corticosteroids triggered a pheochromocytoma crisis. The concomitant use of ß-blockers without preceding α blockade resulted in cardiovascular collapse. Pheochromocytoma crisis must be included in the differential diagnosis of any dramatic haemodynamic collapse after administration of exogenous corticosteroid or ß-blockers.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Feocromocitoma
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Choque Cardiogênico
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Dexametasona
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Corticosteroides
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Antagonistas Adrenérgicos beta
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Glucocorticoides
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article