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. 2021 Mar 22;5(3):ytab092. doi: 10.1093/ehjcr/ytab092
Day 0 Epigastric pain after consuming Levosulpiride, followed by haematemesis
Day 0, 1 h Emergency Department: pH 6.8, PaO2/FiO2 150 mmHg requiring endotracheal intubation; electrocardiogram: sinus tachycardia, ST-segment elevation in anterior and lateral leads; transthoracic echocardiography: akinesia of all middle and apical segments of the left ventricle, left ventricular ejection fraction (LVEF) 20%
Day 0, 2 h Thoracic and abdominal computed tomography scan showing a mass (5 cm) of the left adrenal gland (suggestive of a pheochromocytoma)
Day 0, 3 h Coronary angiography: no evidence of relevant coronary artery disease; left ventricular angiography showing apical ballooning with severe reduction in LV function (LVEF 15%)
Day 0, 4 h Cardiac arrest after Labetalol administration: ventricular fibrillation, CPR, DC-shock 6×, pulseless electrical activity; implantation of Impella CP®, high dose of epinephrine intravenous (i.v.) infusion
Day 1 Tapering and end of epinephrine i.v. infusion
Day 2 Introduction of Doxazosine, Metoprolol, and Amlodipine
Day 3 Introduction of i.v. Urapidil due to resistant hypertension
Day 4 Improved LV function (LVEF 45%), removal of Impella CP®
Day 33 Pheochromocytoma confirmed by significantly increased urinary concentration of metanephrine and normetanephrine
Day 42 Left sided laparoscopic adrenalectomy, uncomplicated
Day 46 Patient’s discharge