title: High blood pressure, ventricular tachycardia and transient left ventricular dysfunction: do not forget pheocromocytoma.
abstract: Pheochromocytoma is a neuroendocrine tumour of the adrenal gland that secretes an excessive amount of catecholamines, leading to a rapid rise and fall in blood pressure, headache, sweating and palpitations. The clinical scenario of pheochromocytoma, however, may be extremely variable and may include atypical cardiovascular manifestations, eventually leading to delays or mistakes in diagnosis. This issue is crucial since a missed diagnosis of pheochromocytoma may imply fatal consequences. This article reports a case of pheochromocytoma presenting with quite atypical cardiovascular manifestations such as transient left ventricular dysfunction and ventricular tachycardia. The pathophysiological determinants underlying uncommon clinical presentations of pheochromocytoma are also discussed. Received for publication 19 May 2011; accepted for publication 10 June 2011.
authors.affiliation: Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome "Sapienza", Sant'Andrea Hospital, Italy. gremao@libero.it
authors.forename: Mario
authors.initials: M
authors.lastname: Gregori
authors.forename: Francesco
authors.initials: F
authors.lastname: Paneni
authors.forename: Michela
authors.initials: M
authors.lastname: D'Agostino
authors.forename: Giuliano
authors.initials: G
authors.lastname: Tocci
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrucci
authors.forename: Carmine
authors.initials: C
authors.lastname: Savoia
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy / Q000652:urine; D000315:Adrenalectomy; D018674:Adrenergic Antagonists / Q000627:therapeutic use; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000652:urine; D001794:Blood Pressure; D004562:Electrocardiography; D004837:Epinephrine / Q000652:urine; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D009638:Norepinephrine / Q000652:urine; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy / Q000652:urine; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology*
chemical_list: D018674:Adrenergic Antagonists; D000959:Antihypertensive Agents; D015415:Biomarkers; D009638:Norepinephrine; D004837:Epinephrine