title: Recurrent urosepsis and cardiogenic shock in an elderly patient with pheochromocytoma.
abstract: Pheochromocytomas are thought to be uncommon in the elderly. However, the prevalence is likely to be higher than reported, as older patients are less likely to be diagnosed due to absence of classical symptoms of sympathetic overactivity and confounding effects of aging, comorbidities, and medications. We describe a hypertensive elderly patient with incidentally diagnosed pheochromocytoma complicated by recurrent urosepsis, cardiomyopathy, and fatal myocardial infarction. Our case demonstrates that, in older hypertensive patients without classical symptoms, orthostatic hypotension and urinary retention, which are common in the elderly, may indicate catecholamine excess and that the deleterious cardiovascular consequences of catecholamine excess in the elderly are not prevented by pharmacological α- and β-blockade.
authors.affiliation: Department of Endocrinology, Changi General Hospital, Singapore 529889.
authors.forename: Joan Joo-Ching
authors.initials: JJ
authors.lastname: Khoo
authors.forename: Vanessa Shu-Chuan
authors.initials: VS
authors.lastname: Au
authors.forename: Richard Yuan-Tud
authors.initials: RY
authors.lastname: Chen