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| Title | Perioperative Management of a Patient with Pheochromocytoma Complicated with Hypertrophic Obstructive Cardiomyopathy- Hemodynamic Control Using Transesophageal Echocardiography |
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| Authors | Noriko Ochiai*, Ryu Okutani**, Ayumi Fujita**, Masahiro Kondo*** |
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| Organization | *Department of Anesthesiology, Hyogo College of Medicine, **Department of Anesthesiology, Hyogo Prefectural Nishi-nomiya Hospital, ***First internal Medicine, Hyogo College of Medicine |
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| Journal | Circulation Control |
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| Volume | 17 |
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| Number | 2 |
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| Page | 253-257 |
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| Year/Month | 1996/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Pheochromocytoma is often associated with catecholamine-induced cardiomyopathy1〜4), but this condition frequently disappears after removal of the tumor. 5,6) For this reason, surgery is preferred in most cases. Hypertrophic cardiomyopathy with left ventricular outflow obstruction, however, may be related to repid changes associated with stimulation during manipulation of the tumor at surgery, aggravation of the left ventricular outflow obstruction, a marked decrease in cardiac output, and even cardiac insufficiency and myocardial infarction. Therefore, an important aspect of the anesthetic management of these patients is the early detection and prevention of these signs. Transesophageal echocardiography (TEE) is considered to be useful in the diagnosis of myocardial infarction and cardiomyopathy7). We adopted this modality as an intraoperative monitor, and found that imaging and quantitative determination by this method enable us a reliable anesthetic control, especially circulatory management. We describe here the anesthetic management, together with the follow-up postsurgical echocardiographic findings until the patient regained normal cardiac function. 「Case Report」A 38-year-old woman weighing 50kg, who was 155cm tall had a history of recurrent chest discomfort. Two years before the present admission, the patient developed severe hypertension but did not receive any antihypertensive therapy. |
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| Practice | Basic medicine |
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