Electrical Storm in a Case of Bilateral Pheochromocytomas
| Autor: | Prabhjot K. Grewal, Stephen S Germana, Leslie Klyachman, Caitlin A Gauvin, Eric Rashba, Abhijeet Singh |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Tachycardia
Male medicine.medical_specialty Adrenal Gland Neoplasms Pheochromocytoma 030204 cardiovascular system & hematology Ventricular tachycardia 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Palpitations Humans Ischemic cardiomyopathy Ejection fraction business.industry Arrhythmias Cardiac General Medicine Articles Middle Aged medicine.disease Defibrillators Implantable 030220 oncology & carcinogenesis Heart failure Ventricular fibrillation Ventricular Fibrillation Cardiology Tachycardia Ventricular medicine.symptom business |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| Popis: | Patient: Male, 63-year-old Final Diagnosis: Electrical storm Symptoms: Hypotension • syncope Medication: — Clinical Procedure: — Specialty: Cardiology Objective: Rare disease Background: Pheochromocytomas are catecholamine-secreting tumors that develop within the chromaffin cells of the adrenal glands. They most commonly present with hypertension, and the classic triad of symptoms is headaches, palpitations, and diaphoresis. Electrical storm (ES) is defined as at least 3 sustained episodes of ventricular tachycardia (VT), ventricular fibrillation (VF), or appropriate shocks from an implanted cardioverter-defibrillator (ICD) within 24 h. We discuss the case of a 63-year-old man with known bilateral pheochromocytomas who presented with ES prompting multiple ICD shocks, possibly exacerbated by catecholamine surge from his adrenal tumors. Case Report: The patient was a 63-year-old man with an extensive medical history including ischemic cardiomyopathy and congestive heart failure with reduced ejection fraction presented with multiple syncopal episodes secondary to persistent monomorphic ventricular tachycardia (MMVT), polymorphic ventricular tachycardia (PMVT), and VF requiring ICD shocks. He had known bilateral pheochromocytomas. ES was attributed to catecholamine excess in the setting of these tumors, so VT ablation was deferred pending tumor removal. Alpha blockade was initiated preoperatively, and the patient subsequently underwent bilateral adrenalectomy; however, he continued to sustain tachyarrhythmias and eventually died despite resuscitative efforts. Conclusions: Bilateral pheochromocytomas are rare adrenal tumors. In even more infrequent situations, they can cause ES secondary to adrenergic stimulation from catecholamine surges. It is worth considering pheochromocytoma in patients with refractory ES, as treating these tumors could potentially reduce the frequency of this dangerous arrhythmia. |
| Databáze: | OpenAIRE |
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