ABSTRACT
This article presents the case of a patient with sudden onset of heart failure caused by transient severe left ventricular dysfunction with the typical pattern of stress-induced cardiomyopathy (takotsubo cardiomyopathy) who had wasp sting a few hours before admission in the presence of a previously asymptomatic pheochromocytoma. There seems to be correlation between the wasp-venom-induced pheochomocytoma crisis and acute onset of heart failure. Once pheocromocytoma is diagnosed, medical therapy is preferable before surgical treatment. This case demonstrates that a previously asymptomatic pheochromocytoma can become clinically relevant by catecholamine-releasing wasp venom causing stress-related cardiomyopathy and that patient history is mandatory for evaluating the cause of sudden clinical outcome.
Subject(s)
Adrenal Gland Neoplasms/complications , Adrenal Gland Neoplasms/physiopathology , Heart Failure/etiology , Heart Failure/physiopathology , Hypertension, Malignant/etiology , Hypertension, Malignant/physiopathology , Insect Bites and Stings/complications , Insect Bites and Stings/physiopathology , Pheochromocytoma/complications , Pheochromocytoma/physiopathology , Sympathetic Nervous System/physiopathology , Takotsubo Cardiomyopathy/etiology , Takotsubo Cardiomyopathy/physiopathology , Wasps , Adrenal Gland Neoplasms/therapy , Aged , Animals , Catecholamines/physiology , Critical Care , Diagnosis, Differential , Echocardiography , Heart Failure/therapy , Humans , Hyperglycemia/etiology , Hyperglycemia/physiopathology , Hyperglycemia/therapy , Hypertension, Malignant/therapy , Incidental Findings , Insect Bites and Stings/therapy , Male , Pheochromocytoma/therapy , Takotsubo Cardiomyopathy/therapyABSTRACT
A favorable attitude of health professionals to organ donation can positively influence the decision of families of potential donors. By increasing health professionals knowledge about donation and transplantation and qualifying them to disseminate information, education has produced a positive response to increase the insufficient number of donors. Educating students early in their careers may become crucial in this setting. In order to supply the necessary information about the process of donation and transplantation, a medical school in association with the Hospital Transplant Coordination Department created an educational program of organ donation and transplantation. This course is intended for medical, biomedical, and nutrition students. The objective of our program is to supply basic knowledge about organ donation and transplantation to students of medicine, nutrition, and biomedicine and to enhance their commitment to this process. Each semester, 50 to 90 students are enrolled in the course, which involves a total of 25 hours. Various aspects are approached such as brain death, donor management, political and legal aspects of donation, and skin, lung, bone marrow, heart, pancreas, liver, and kidney transplantation. Between March 2006 and June 2007, three courses were carried out and 200 students were trained. The students evaluated the course and rated it as excellent, concluding that it contributed to their education. Their attitude toward organ donation and transplantation was strongly positive at the end of the course. This project aims to educate and stimulate students in the process of organ donation and transplantation and should be implemented in other medical schools.
