TAILIEUCHUNG - Báo cáo y học: "Torsades de pointes during laparoscopic adrenalectomy of a pheochromocytoma: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Torsades de pointes during laparoscopic adrenalectomy of a pheochromocytoma: a case report. | van der Heide et al. Journal of Medical Case Reports 2011 5 368 http content 5 1 368 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Torsades de pointes during laparoscopic adrenalectomy of a pheochromocytoma a case report Kinge van der Heide1 Ann de Haes2 Gotz JK Wietasch3 Ans CP Wiesfeld4 and Herman GD Hendriks3 Abstract Introduction Torsades de pointes is a rare but potentially lethal arrhythmia. The amount of literature available on Torsades de pointes occurring in patients with pheochromocytoma is limited and we found no literature describing this dysrhythmia in a patient with pheochromocytoma under anesthesia. Case presentation We describe the case of a 42-year-old Caucasian woman without QT prolongation preoperatively with recurrent Torsades de pointes during laparoscopic removal of a pheochromocytoma. Torsades de pointes mainly occurs in the setting of a prolonged QT interval. This patient neither had a prolonged QT preoperatively nor was her family history suspect for a congenital long QT syndrome. Most likely our patient had an acquired long QT syndrome elicited by the combination of flecainide hypomagnesemia and adrenergic stimulation during manipulation of the tumor. Conclusion We show that in the case of a surgical pheochromocytoma removal perioperative conditions can elicit an acquired or previously unknown congenital long QT syndrome. Therefore preoperative a- and p-blockade is advised QT-prolonging drugs should be avoided and potassium and magnesium plasma levels should be kept at normal to high levels. Introduction Pheochromocytomas are catecholamine-producing neuroendocrine tumors arising from the chromaffin cells of the adrenal medulla or extraadrenal paraganglia. A pheochromocytoma is a potential life-threatening disease with a high risk of cardiovascular complications such as myocardial infarction arrhythmias catecholamine-induced cardiomyopathy stroke and pulmonary edema. It is a rare neoplasm occurring in .

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