0 day |
Extirpation of a benign thyroglossal duct cyst |
0 day 10 h |
Cardiogenic shock with severely impaired systolic left ventricular function |
0 day 14 h |
Coronary angiography: no evidence of relevant coronary artery disease |
0 day 22 h |
Admission to Heart Center Dresden (PaO2/FiO2 30 mmHg, 2.5 µg/kg/min norepinephrine |
Transthoracic echocardiography: suspected for a reverse takotsubo cardiomyopathy because of akinesia of all basal and middle segments of the left ventricle with preserved kinetics of the apex (left ventricular ejection fraction, LVEF 15%) |
0 day 24 h |
Implantation of Impella CP®
|
1 day 3 h |
Implantation of veno-arterial extracorporeal membrane oxygenation (va-ECMO) due to deterioration of right ventricular function and persistent severe respiratory insufficiency |
1 day 20 h |
Computed tomography scan detects a lesion of the adrenal gland suspicious of a pheochromocytoma |
6 days 10 h |
End of intravenous norepinephrine administration |
7 days 0 h |
Explanation of Impella CP® and va-ECMO due to improved biventricular function (LVEF 40%, TAPSE 19 mm) and respiratory situation (PaO2/FiO2 150 mmHg) |
8 days |
Pheochromocytoma was confirmed by significantly increased plasma concentrations of metanephrine/normetanephrine |
9 days |
Initiation of non-specific α adrenergic receptor inhibition with phenoxybenzamine |
28 days |
Metaiodobenzylguanidine scintigraphy: no evidence for metastases of the pheochromocytoma or coincident paragangliomas |
33 days |
Laparoscopic excision of the pheochromocytoma |
49 days |
Discharge to rehabilitation with normalized biventricular function (LVEF 55%, TAPSE 25 mm) |