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Pheochromocytoma: cyclic attacks of hypertension alternating with hypotension

Nature Clinical Practice Cardiovascular Medicine volume 5, pages 53–57 (2008)Cite this article

Abstract

Background A 52-year-old woman was admitted to hospital with recurrent episodes of chest and abdominal pain, dyspnea, palpitations and diaphoresis. Continuous blood pressure recordings revealed rhythmic alternation between episodes of severe hypertension and episodes of hypotension. This cyclic hemodynamic crisis continued for 2 hours, with each cycle lasting around 15 min.

Investigations Physical examination, electrocardiography, chest radiography, continuous intra-arterial pressure monitoring, blood and urine analysis, echocardiography, abdominal CT and 131I miodobenzylguanidine scanning.

Diagnosis Pheochromocytoma—a catecholamine secreting tumor.

Management Intravenous phentolamine and fluids, oral doxazosin and surgical removal of the tumor.

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Figure 1: Simultaneous recordings of the patient's heart rate and arterial blood pressure (BP).

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Author information

Authors and Affiliations

  1. and S Mizrahi is a Professor of Medicine and Director of the Department of Surgery A at Soroka University Medical Center, SL Kobal is Director of the Cardiac Stress Test Unit, E Paran is a Professor of Medicine and Director of the Hypertension Unit, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,

    Sergio L Kobal, Esther Paran & Solly Mizrahi

  2. A Jamali is a Senior Cardiologist and RJ Siegel is Director of the Noninvasive Cardiology Department at Cedars Sinai Medical Center, and a Professor of Medicine at the University of California, Los Angeles, USA.,

    Aamer Jamali & Robert J Siegel

  3. J Leor is an Associate Professor of Cardiology at Tel-Aviv University and Director of the Neufeld Cardiac Research Institute at the Sheba Medical Center, Tel-Hashomer, Israel.,

    Jonathan Leor

Authors
  1. Sergio L Kobal
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  2. Esther Paran
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  3. Aamer Jamali
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  4. Solly Mizrahi
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  5. Robert J Siegel
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  6. Jonathan Leor
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Corresponding author

Correspondence to Jonathan Leor.

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The authors declare no competing financial interests.

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Kobal, S., Paran, E., Jamali, A. et al. Pheochromocytoma: cyclic attacks of hypertension alternating with hypotension. Nat Rev Cardiol 5, 53–57 (2008). https://doi.org/10.1038/ncpcardio1054

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  • DOI: https://doi.org/10.1038/ncpcardio1054

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