Concomitant coronary artery disease (CAD) and pheochromocytoma are rare. Patients with advanced CAD requiring coronary artery bypass graft (CABG) surgery and clinically active pheochromocytoma present a challenge to anesthesiologists. The risk is much higher if the patient is an anemic Jehovah's Witness because these patients refuse to receive blood or blood products, even when faced with a life-threatening hemorrhage. To our knowledge, this is the first case to describe the anesthetic management of an anemic Jehovah's Witness patient with pheochromocytoma presenting for off-pump CABG surgery.

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