Cardiovascular manifestations of pheochromocytoma

Liao, Wei-Ber; Liu, Chu-Feng; Chiang, Ching-Wen; Kung, Chia-Te; Lee, Chi‐Wei

doi:10.1053/ajem.2000.7341

Cited by 101 publications

(59 citation statements)

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“…These symptoms are caused by catecholamines, which induce vasoconstriction of the coronary arteries while simultaneously increasing myocardial oxygen demand through stimulation of heart rate and cardiac contractility. The presentation and electrocardiographic changes, such as ST-segment elevation or depression [69,71,72], negative T-waves, and a prolonged QTinterval (present in 7%-35% of patients [40,73]), may resemble those of patients with myocardial ischemia or infarction due to heart disease; however, patients with pheochromocytoma may also have other symptoms due to catecholamine excess, such as severe hypertension or headache, profuse sweating, or intense pallor. A history of episodic attacks is even more helpful.…”

Section: Myocardial Ischemia and Myocardial Infarctionmentioning

confidence: 99%

Emergencies Caused by Pheochromocytoma, Neuroblastoma, or Ganglioneuroma

Brouwers

Eisenhofer

Lenders

et al. 2006

Endocrinology and Metabolism Clinics of North America

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This article reviews emergency situations caused by diseases of the sympathetic nervous system. Pheochromocytoma is discussed first and most extensively, because there are numerous reports in the literature on patients with (unsuspected) pheochromocytoma presenting as an emergency. Two other tumors of the sympathetic nervous system are then discussed that less commonly result in endocrine emergencies: neuroblastoma and ganglioneuroma. PheochromocytomaParagangliomas are rare catecholamine-producing tumors derived from chromaffin cells that can be fatal if left undiagnosed.

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Section: Myocardial Ischemia and Myocardial Infarctionmentioning

confidence: 99%

Emergencies Caused by Pheochromocytoma, Neuroblastoma, or Ganglioneuroma

Brouwers

Eisenhofer

Lenders

et al. 2006

Endocrinology and Metabolism Clinics of North America

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“…Cardiovascular sequelae have been well documented in the literature and include cardiac hypertrophy, dilated cardiomyopathy, ischemic heart disease, myocardial infarction, cardiac arrhythmias, and cardiogenic shock. 19,20,27,34 Persistent hemodynamic instability in the absence of catecholamine crises has been attributed to long-lasting vascular changes. Remodeling of the blood vessels has been shown to occur with prolonged sympathetic stimulation, thereby placing the patient at greater risk for a cardiovascular event.…”

Section: Discussionmentioning

confidence: 99%

High incidence of morbidity following resection of metastatic pheochromocytoma in the spine

Kaloostian

Zadnik

Kim

et al. 2014

SPI

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Pheochromocytomas of the spine are uncommon and require careful preoperative planning. The authors retrospectively reviewed the charts of 5 patients with metastatic spinal pheochromocytoma who had undergone surgical treatment over the past 10 years at their medical center. They reviewed patient age, history of pheochromocytoma resection, extent and location of metastases, history of alpha blockage, surgical level, surgical procedure, postoperative complications, tumor recurrence, and survival. Metastases involved the cervical (1 patient), thoracic (3 patients), and lumbar (2 patients) levels. Preoperative treatment included primary pheochromocytoma resection, chemotherapy, alpha blockade, embolization, and radiation. Three patients had tumor recurrence, and 2 underwent 2-stage reoperations for tumor extension. Hemodynamic complications were common: 2 patients developed pulseless electrical activity arrest within 4 months after surgery, 1 patient had profound postoperative tachycardia with fever and an elevated creatine kinase level, and 1 patient experienced transient postoperative hypotension and paraplegia. One patient died of complications related to disseminated cerebral and spinal disease. With careful preoperative and surgical management, patients with symptomatic metastatic spinal pheochromocytoma can benefit from aggressive surgical treatment. Postoperative cardiovascular complications are common even months after surgery, and patients should be closely monitored long term.

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“…8,9 Repolarization abnormalities associated with hyperadrenergic states can cause QT prolongation and lethal arrhythmia, including Torsades de pointes. 10 The reported cardiac complications of this tumour include hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmias, myocardial ischemia, and SCD.…”

Section: Introductionmentioning

confidence: 99%