RESUMO
Pheochromocytoma is a catecholamine-secreting tumor of the adrenal glands whose typical presentation includes the triad of headache, palpitations, and diaphoresis. Pheochromocytoma crisis is an urgent medical condition whose diagnosis and management constitute a challenge for physicians. We present the case of a 55-year-old man who developed cardiogenic shock in the setting of a pheochromocytoma crisis. After stabilizing blood pressure with combined administration of α- and ß-blockers, the tumor was surgically removed. Our diagnostic and therapeutic challenges are discussed.
Assuntos
Neoplasias das Glândulas Suprarrenais/complicações , Neoplasias das Glândulas Suprarrenais/diagnóstico , Feocromocitoma/complicações , Feocromocitoma/diagnóstico , Choque Cardiogênico/diagnóstico , Choque Cardiogênico/etiologia , Neoplasias das Glândulas Suprarrenais/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Feocromocitoma/cirurgia , Choque Cardiogênico/prevenção & controle , Resultado do TratamentoRESUMO
Reported is a technique that was used to treat a distal left anterior descending (LAD) perforation in a patient undergoing percutaneous coronary intervention (PCI) for distal LAD total occlusion. The perforation was successfully treated by re-occluding the LAD with implantation of a polytetrafluoroethylene (PTFE)-covered stent in a diagonal branch extending to the LAD (side branch graft stenting technique) delivered using the dual catheter technique. This approach is proposed as an alternative bail-out technique that can be used in cases where other treatment options for coronary perforation are either unavailable or potentially not successful, especially during PCI for total occlusions, where the disadvantage of main vessel occlusion is already present.