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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Ibrahim, Majd Mungee, Sudhir Banga, Sandeep Venkatapuram, Suneetha |
| Description | Author Affiliation: Ibrahim M ( Department of Internal Medicine/Division of Cardiology, University of Illinois College of Medicine at Peoria/OSF Saint Francis Medical Center, Peoria, Illinois, USA.); Banga S ( Department of Internal Medicine/Division of Cardiology, University of Illinois College of Medicine at Peoria/OSF Saint Francis Medical Center, Peoria, Illinois, USA.); Venkatapuram S ( Department of Internal Medicine/Division of Cardiology, University of Illinois College of Medicine at Peoria/OSF Saint Francis Medical Center, Peoria, Illinois, USA.); Mungee S ( Department of Internal Medicine/Division of Cardiology, University of Illinois College of Medicine at Peoria/OSF Saint Francis Medical Center, Peoria, Illinois, USA.) |
| Abstract | We report a case of a 39-year-old woman who presented to the emergency department (ED) with symptoms of pharyngitis and fever. Diagnosed with streptococcal pharyngitis, she received antibiotics and dexamethasone, and was discharged. Within 24â h she returned to the ED with signs and symptoms of an acute coronary syndrome; she was thus given ß-blockers. Her coronary angiogram was normal. She developed cardiogenic shock with an ejection fraction (EF) of 10% and apical ballooning on echocardiography. Her condition improved with optimal medical therapy. Subsequent testing weeks later confirmed the presence of a pheochromocytoma. Following prazosin and an adrenalectomy, all her antihypertensive medications were weaned and her EF normalised. We believe the high-dose exogenous corticosteroids triggered a pheochromocytoma crisis. The concomitant use of ß-blockers without preceding blockade resulted in cardiovascular collapse. Pheochromocytoma crisis must be included in the differential diagnosis of any dramatic haemodynamic collapse after administration of exogenous corticosteroid or ß-blockers. |
| Volume Number | 2015 |
| e-ISSN | 1757790X |
| Journal | BMJ Case Reports |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Adrenal Cortex Hormones Adverse Effects Adrenergic Beta-Antagonists Dexamethasone Glucocorticoids Pheochromocytoma Complications Shock, Cardiogenic Etiology Acute Coronary Syndrome Drug Therapy Adrenalectomy Adult Diagnosis, Differential Dose-Response Relationship, Drug Female Humans Pharyngitis Chemically Induced Case Reports Journal Article Multidisciplinary |
| Content Type | Text |
| Resource Type | Article |
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