title: Resistant hypertension in an obese patient with obvious obstructive sleep apnea and occult pheochromocytoma.
abstract: We report the case of a 34-year-old male patient who presented with generalized weakness, poorly controlled hypertension, nocturnal hypertension spikes, and morning headaches. The history of resistant hypertension, obesity, enlarged neck size, and loud irregular snoring strongly suggested obstructive sleep apnea (OSA). To exclude other possible causes of resistant hypertension, the patient underwent an abdominal ultrasound examination, which revealed a lesion in the left adrenal gland area. A pheochromocytoma was successfully removed via laparoscopic adrenalectomy, and both his hypertension and OSA responded dramatically. This case highlights the importance of excluding all causes of resistant hypertension regardless of the initial diagnosis.
authors.affiliation: Department of Cardiology, The Medical University of Warsaw, Warsaw, Poland. filip.szymanski@wum.edu.pl
authors.forename: Filip M
authors.initials: FM
authors.lastname: Szymanski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Karpinski
authors.forename: Anna
authors.initials: A
authors.lastname: Hrynkiewicz-Szymanska
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipiak
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination / Q000379:methods; D015992:Body Mass Index; D004351:Drug Resistance; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009765:Obesity / Q000150:complications / Q000175:diagnosis*; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D017286:Polysomnography; D018570:Risk Assessment; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents