Case Report: Veno-Arteriovenous Extracorporeal Membrane Oxygenation for Management of Pheochromocytoma-Induced Cardiac Arrest in a Post-Partum Patient.
Kwame Agyei, Hassan M Fahmi, Terri Sun
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Case in brief
A 34-year-old woman, two days postpartum, was admitted to intensive care with hypertensive crisis and respiratory failure. CT showed an 18-cm left adrenal mass suspicious for pheochromocytoma. Following cardiac arrest and recurrent destabilizing arrhythmias, she was supported with veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO). After successful decannulation, she underwent uncomplicated resection of the adrenal mass.
What made this case unusual
The report describes V-AV ECMO support for pheochromocytoma-associated cardiac arrest with recurrent arrhythmias, rather than the VA-ECMO configuration previously used for pheochromocytoma support.
Diagnostic / clinical pearl
In a postpartum patient with hypertensive crisis and respiratory failure, an adrenal mass may raise suspicion for pheochromocytoma; severe cardiac instability in this case was managed with V-AV ECMO before tumor resection.