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Mechanical bridge to recovery in pheochromocytoma myocarditis

Nature Reviews Cardiology volume 6, pages 482–487 (2009)Cite this article

Abstract

Background. A 27-year-old male presented with exercise-related symptoms of chest tightness, palpitations, breathlessness and severe headache, with occasional nausea, dizziness, and blurred vision. Apart from a family history of coronary artery disease there was no other medical history of note.

Investigations. Clinical examination, treadmill exercise test (Bruce protocol), electrocardiography, MRI of the abdomen, blood tests, chest radiography, coronary angiography, two-dimensional echocardiography, transesophageal echocardiography, microscopy of the tumor, 131iodine metaiodobenzylguanidine scan.

Diagnosis. Pheochromocytoma myocarditis.

Management. Intra-aortic balloon pump, levosimendan and dobutamine infusion, α-blockade with phentolamine, surgical removal of the pheochromocytoma, Levitronix® (Levitronix LLC, Waltham, MA) left ventricular assist device implantation.

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Figure 1
Figure 2: CT scan after the patient had been transferred to a surgical center.
Figure 3: Tumor histology.

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Acknowledgements

Written consent for publication was obtained from the patient.

Charles P. Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the MedscapeCME-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. John Radcliffe Hospital, Oxford, UK

    Stephen Westaby, Ashwin Shahir, Gregory Sadler, Fidelma Flynn & Oliver Ormerod

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Correspondence to Stephen Westaby.

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Westaby, S., Shahir, A., Sadler, G. et al. Mechanical bridge to recovery in pheochromocytoma myocarditis. Nat Rev Cardiol 6, 482–487 (2009). https://doi.org/10.1038/nrcardio.2009.58

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