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A Rescued Case of Extra-Adrenal Pheochromocytoma Complicated by Cardiogenic Shock,Acute Heart Failure,and Catecholamine Cardiomyopathy Koki Mise 1 , Tetsuya Sato 1 , Toshihiro Sarashina 1 , Haruaki Kawai 1 , Soichiro Fuke 1 , Tetsuya Ikeda 1 , Hironori Saito 1 , Toru Ujihira 1 , Tadayoshi Kunitomo 2 , Yuri Nagano 3 , Hiroaki Tokioka 3 1Department of Cardiology, Japanese Red Cross Okayama Hospital 2Department of Pathology, Japanese Red Cross Okayama Hospital 3Department of Anesthesiology, Japanese Red Cross Okayama Hospital Keyword: 異所性褐色細胞腫 , カテコラミン心筋症 , ショック , extra-adrenal pheochromocytoma , catecholamine cardiomyopathy , shock pp.961-967
Published Date 2010/9/15
DOI https://doi.org/10.11477/mf.1404101551
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 A 55-year-old woman was admitted to our hospital with worsening back pain after her daughter's wedding. Physical examination on admission demonstrated a heart rate of 98/min and blood pressure of 91/70mmHg. ECG showed ST segment elevation in leadsⅡ, Ⅲ, and aVF. Chest X-ray demonstrated infiltrative shadows in the right upper lobe, and echocardiography demonstrated extensive akinesis of the anterolateral, apical, and diaphragmatic segments with a global ejection fraction of 18%. Abdominal CT demonstrated a non-uniform mass measuring 6cm in diameter with rich blood flow in the porta hepatis. Worsening pulmonary shadow just after admission caused hypotension and shock, which required emergency mechanical ventilation in the intensive care unit. The control of hemodynamics was poor and systolic blood pressure was 80-90mmHg even with cathecholamine and vasopressin;PaO2 was 90-100 Torr following diuretics, afterload-reducing medication, and mechanical ventilation. After two weeks of intensive care therapy, surgery was performed on day 38 under a pathological diagnosis of paraganglioma. The patient was ambulatory when discharged home on day 46.


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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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