Bouaiyda A, Jeddab A, Mounir K, Jaafari A, Bensghir M, Balkhi H
Department of Anesthesia and Intensive Care, Military Teaching Hospital Mohammed V, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco.
Department of Anesthesia and Intensive Care, Military Teaching Hospital Mohammed V, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco.
Int J Surg Case Rep. 2025 Aug;133:111544. doi: 10.1016/j.ijscr.2025.111544. Epub 2025 Jun 19.
Anesthetic management of pheochromocytoma is challenging due to the risk of severe hemodynamic instability. Recent evidence suggests an association with Takotsubo syndrome, complicating perioperative care. Awareness of this complication is crucial for optimizing management and improving outcomes.
We report a 42-year-old female undergoing preoperative evaluation for an adrenal mass, diagnosed as pheochromocytoma. Echocardiography revealed dilated cardiomyopathy consistent with Takotsubo syndrome. Preoperative optimization included alpha- and beta-blockade. Anesthetic management focused on maintaining hemodynamic stability with invasive monitoring. The surgery was uneventful, and the patient recovered in the intensive care unit with gradual improvement in cardiac function.
This case illustrates the link between pheochromocytoma and Takotsubo syndrome, likely triggered by catecholamine excess. It highlights the importance of careful preoperative preparation and vigilant intraoperative monitoring to minimize cardiovascular complications.
Takotsubo syndrome should be considered in patients with pheochromocytoma due to its impact on anesthetic management. Comprehensive perioperative care is essential for successful outcomes.
由于存在严重血流动力学不稳定的风险，嗜铬细胞瘤的麻醉管理具有挑战性。最近的证据表明其与应激性心肌病有关，这使围手术期护理变得复杂。认识到这种并发症对于优化管理和改善预后至关重要。
我们报告一名42岁女性，因肾上腺肿物接受术前评估，诊断为嗜铬细胞瘤。超声心动图显示符合应激性心肌病的扩张型心肌病。术前优化包括使用α和β受体阻滞剂。麻醉管理侧重于通过有创监测维持血流动力学稳定。手术过程顺利，患者在重症监护病房康复，心脏功能逐渐改善。
该病例说明了嗜铬细胞瘤与应激性心肌病之间的联系，可能由儿茶酚胺过量引发。它强调了仔细的术前准备和术中密切监测以尽量减少心血管并发症的重要性。
由于应激性心肌病对麻醉管理的影响，嗜铬细胞瘤患者应考虑到这一情况。全面的围手术期护理对于取得成功的预后至关重要。
