Torsades de pointes during laparoscopic adrenalectomy of a pheochromocytoma: a case report

Kinge van der Heide, Ann de Haes, Götz J. K. Wietasch, Ans C. P. Wiesfeld, Herman G. D. Hendriks*

*Bijbehorende auteur voor dit werk

    OnderzoeksoutputAcademicpeer review

    12 Citaten (Scopus)
    24 Downloads (Pure)

    Samenvatting

    INTRODUCTION: Torsades de pointes is a rare but potentially lethal arrhythmia. The amount of literature available on Torsades de pointes occurring in patients with pheochromocytoma is limited, and we found no literature describing this dysrhythmia in a patient with pheochromocytoma under anesthesia.

    CASE PRESENTATION: We describe the case of a 42-year-old Caucasian woman without QT prolongation preoperatively with recurrent Torsades de pointes during laparoscopic removal of a pheochromocytoma. Torsades de pointes mainly occurs in the setting of a prolonged QT interval. This patient neither had a prolonged QT preoperatively nor was her family history suspect for a congenital long QT syndrome. Most likely, our patient had an acquired long QT syndrome, elicited by the combination of flecainide, hypomagnesemia and adrenergic stimulation during manipulation of the tumor.

    CONCLUSION: We show that in the case of a surgical pheochromocytoma removal, perioperative conditions can elicit an acquired or previously unknown congenital long QT syndrome. Therefore, preoperative α- and β-blockade is advised, QT-prolonging drugs should be avoided and potassium and magnesium plasma levels should be kept at normal to high levels.

    Originele taal-2English
    Artikelnummer368
    Aantal pagina's5
    TijdschriftJournal of Medical Case Reports
    Volume5
    DOI's
    StatusPublished - 12-aug-2011

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