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Mechanical bridge to recovery in pheochromocytoma myocarditis
Stephen Westaby1, Ashwin Shahir, Gregory Sadler
1Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK. stephen.westaby@ orh.nhs.uk
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, (131)iodine metaiodobenzylguanidine scan.
Diagnosis:
Pheochromocytoma myocarditis.
Management:
Intra-aortic balloon pump, levosimendan and dobutamine infusion, alpha-blockade with phentolamine, surgical removal of the pheochromocytoma, Levitronix (Levitronix LLC, Waltham, MA) left ventricular assist device implantation.
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