Back to Search
Start Over
Cardiorespiratory crisis at the end of pregnancy: a case of pheochromocytoma.
- Source :
-
Middle East journal of anaesthesiology [Middle East J Anaesthesiol] 2013 Jun; Vol. 22 (2), pp. 195-202. - Publication Year :
- 2013
-
Abstract
- Pheochromocytoma during pregnancy is extremely rare. Its clinical manifestation includes hypertension with various clinical presentations, possibly resembling those of pregnancy-induced hypertension. The real challenge for clinicians is differentiating pheochromocytoma from other causes of hypertension (preeclampsia, gestational hypertension, and pre-existing or essential hypertension), from other cause of pulmonary edema (preeclampsia, peripartum cardiomyopathy, stress or Takotsubo cardiomyopathy, pre-existing cardiac disease [mitral stenosis], and high doses betamimetics), and from other causes of cardiovascular collapse (pulmonary embolism, and amniotic fluid embolism). Although, several cases of pheochromocytoma during pregnancy have been published, fetal and maternal mortalities due to undiagnosed cases are still reported. We report a case of a patient whose delivery by cesarean section was complicated by severe hemodynamic instability resulting in a cardiac arrest. Later on, pheochromocytoma was suspected based on computed tomography (CT) scan findings. Diagnosis was confirmed with special biochemical investigations that showed markedly elevated catecholamines in urine and metanephrines in serum, and later by histopathology of the excised left adrenal mass. This case illustrates the difficulty of diagnosing pheochromocytoma in pregnancy and raises the awareness to when this rare disease should be suspected.
- Subjects :
- Adrenal Gland Neoplasms surgery
Adult
Cardiopulmonary Resuscitation methods
Catecholamines urine
Cesarean Section
Diagnosis, Differential
Female
Heart Arrest therapy
Humans
Metanephrine blood
Pheochromocytoma complications
Pheochromocytoma surgery
Pregnancy
Pregnancy Complications, Neoplastic surgery
Pregnancy Trimester, Third
Tomography, X-Ray Computed methods
Adrenal Gland Neoplasms diagnosis
Heart Arrest etiology
Pheochromocytoma diagnosis
Pregnancy Complications, Neoplastic diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 0544-0440
- Volume :
- 22
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Middle East journal of anaesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 24180171