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Pheochromocytoma, Fulminant Heart Failure, and a Phenylephrine Challenge. The Perioperative Management of Adrenalectomy in a Jehovah’s Witness Patient: A Case Report

Sarah A. Bachman

Sarah A. Bachman

Dartmouth-Hitchcock Medical CenterLebanon, USA
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Bachman, Sarah A.
, 
Ryan S. Peterson

Ryan S. Peterson

Dartmouth-Hitchcock Medical CenterLebanon, USA
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Peterson, Ryan S.
, 
Peter S. Burrage

Peter S. Burrage

Dartmouth-Hitchcock Medical CenterLebanon, USA
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Burrage, Peter S.
 and 
Leigh C Hickerson

Leigh C Hickerson

Dartmouth-Hitchcock Medical CenterLebanon, USA
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Hickerson, Leigh C
  
Nov 13, 2021
Pheochromocytoma, Fulminant Heart Failure, and a Phenylephrine Challenge. The Perioperative Management of Adrenalectomy in a Jehovah’s Witness Patient: A Case Report's Cover Image
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Article Category: Case report
Published Online: Nov 13, 2021
Page range: 55 - 60
Received: Apr 06, 2021
Accepted: Oct 10, 2021
DOI: https://doi.org/10.2478/jccm-2021-0038
Keywords
© 2022 Sarah A. Bachman, Ryan S. Peterson, Peter S. Burrage, Leigh C Hickerson, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Fig. 1

Hemodynamic fluctuations during hospitalization. Time markers for initiation of beta blockade and surgery are superimposed.
Hemodynamic fluctuations during hospitalization. Time markers for initiation of beta blockade and surgery are superimposed.

Perioperative goals for pheochromocytoma, stress cardiomyopathy, and acute decompensated heart failure [19]

Pheochromocytoma Stress Cardiomyopathy ADHF
Preoperative Alpha Blockade Afterload reduction Afterload reduction
Optimization Antiarrhythmic Antiarrhythmic Antiarrhythmic/ICD
Volume loading Diuretics Diuretics
Beta Blockade Beta blockade/ACEI (chronic Beta blockade/ACEI (chronic
stage/recovery) MCS stage/recovery) MCS
Intraoperative Afterload reduction Vol- Afterload reduction Maintain cardiac output
Hemodynamic Goals ume resuscitation Avoid volume overload Avoid volume overload
Expected Recovery 10 days - 6 weeks 1-4 weeks Chronic, progressive
Language:
English
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4 times per year
Journal Subjects:
Medicine, Clinical Medicine, Internal Medicine, Internal Medicine, other, Surgery, Surgery, other, Anaesthesiology, Emergency Medicine and Intensive-Care Medicine
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