Postpartum reverse-Takotsubo from pheochromocytoma diagnosed by bedside point-of-care ultrasound: A case report
Point-of-care ultrasound is invaluable in the setting of obstetric anesthesia, where the differential diagnosis for dyspnea, hypoxemia and/or hemodynamic abnormalities is broad. This report describes a previously apparently healthy parturient with an uncomplicated pregnancy at 35-weeks gestation wh...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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CINQUILL Medical Publishers Inc.
2020-11-01
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| Series: | POCUS Journal |
| Subjects: | |
| Online Access: | https://ojs.library.queensu.ca/index.php/pocus/article/view/14432 |
| _version_ | 1797998776477024256 |
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| author | Jordan K. Leitch Anthony M.-H. Ho Rene Allard Glenio B. Mizubuti |
| author_facet | Jordan K. Leitch Anthony M.-H. Ho Rene Allard Glenio B. Mizubuti |
| author_sort | Jordan K. Leitch |
| collection | DOAJ |
| description |
Point-of-care ultrasound is invaluable in the setting of obstetric anesthesia, where the differential diagnosis for dyspnea, hypoxemia and/or hemodynamic abnormalities is broad. This report describes a previously apparently healthy parturient with an uncomplicated pregnancy at 35-weeks gestation who underwent an emergency cesarean section under general anesthesia due to severe acute abdominal pain and fetal bradycardia. Intraoperatively, she presented with severe hypertension and tachycardia that were difficult to control and associated with ischemic ECG changes. In the immediate postoperative period, she developed retrosternal tightness and dyspnea, and a bedside point-of-care ultrasound scan revealed a grossly dilated and hypokinetic left ventricle, as well as diffuse B-lines throughout all lung fields – consistent with cardiogenic pulmonary edema. She was admitted to the intensive care unit, where she recovered over several days. Pheochromocytoma was subsequently diagnosed, and she eventually underwent uneventful elective adrenalectomy after appropriate endocrine and hemodynamic optimization.
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| first_indexed | 2024-04-11T10:54:05Z |
| format | Article |
| id | doaj.art-488d9c0671e04128b7f4fdf44c15ca98 |
| institution | Directory Open Access Journal |
| issn | 2369-8543 |
| language | English |
| last_indexed | 2024-04-11T10:54:05Z |
| publishDate | 2020-11-01 |
| publisher | CINQUILL Medical Publishers Inc. |
| record_format | Article |
| series | POCUS Journal |
| spelling | doaj.art-488d9c0671e04128b7f4fdf44c15ca982022-12-22T04:28:50ZengCINQUILL Medical Publishers Inc.POCUS Journal2369-85432020-11-015210.24908/pocus.v5i2.14432Postpartum reverse-Takotsubo from pheochromocytoma diagnosed by bedside point-of-care ultrasound: A case reportJordan K. Leitch0Anthony M.-H. Ho1Rene Allard2Glenio B. Mizubuti3Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Queen’s University, Kingston ON, CanadaDepartment of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Queen’s University, Kingston ON, CanadaDepartment of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Queen’s University, Kingston ON, CanadaDepartment of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Queen’s University, Kingston ON, Canada Point-of-care ultrasound is invaluable in the setting of obstetric anesthesia, where the differential diagnosis for dyspnea, hypoxemia and/or hemodynamic abnormalities is broad. This report describes a previously apparently healthy parturient with an uncomplicated pregnancy at 35-weeks gestation who underwent an emergency cesarean section under general anesthesia due to severe acute abdominal pain and fetal bradycardia. Intraoperatively, she presented with severe hypertension and tachycardia that were difficult to control and associated with ischemic ECG changes. In the immediate postoperative period, she developed retrosternal tightness and dyspnea, and a bedside point-of-care ultrasound scan revealed a grossly dilated and hypokinetic left ventricle, as well as diffuse B-lines throughout all lung fields – consistent with cardiogenic pulmonary edema. She was admitted to the intensive care unit, where she recovered over several days. Pheochromocytoma was subsequently diagnosed, and she eventually underwent uneventful elective adrenalectomy after appropriate endocrine and hemodynamic optimization. https://ojs.library.queensu.ca/index.php/pocus/article/view/14432Point-of-Care UltrasoundPregnancyCardiomyopathyPheochromocytomaCardiogenic shock |
| spellingShingle | Jordan K. Leitch Anthony M.-H. Ho Rene Allard Glenio B. Mizubuti Postpartum reverse-Takotsubo from pheochromocytoma diagnosed by bedside point-of-care ultrasound: A case report POCUS Journal Point-of-Care Ultrasound Pregnancy Cardiomyopathy Pheochromocytoma Cardiogenic shock |
| title | Postpartum reverse-Takotsubo from pheochromocytoma diagnosed by bedside point-of-care ultrasound: A case report |
| title_full | Postpartum reverse-Takotsubo from pheochromocytoma diagnosed by bedside point-of-care ultrasound: A case report |
| title_fullStr | Postpartum reverse-Takotsubo from pheochromocytoma diagnosed by bedside point-of-care ultrasound: A case report |
| title_full_unstemmed | Postpartum reverse-Takotsubo from pheochromocytoma diagnosed by bedside point-of-care ultrasound: A case report |
| title_short | Postpartum reverse-Takotsubo from pheochromocytoma diagnosed by bedside point-of-care ultrasound: A case report |
| title_sort | postpartum reverse takotsubo from pheochromocytoma diagnosed by bedside point of care ultrasound a case report |
| topic | Point-of-Care Ultrasound Pregnancy Cardiomyopathy Pheochromocytoma Cardiogenic shock |
| url | https://ojs.library.queensu.ca/index.php/pocus/article/view/14432 |
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