Hypertensive Crisis, Catecholamine Cardiomyopathy, and Death Associated with Pseudoephedrine use in a Patient with Pheochromocytoma

Sizemore, Glen W.; Scrogin, Karie E.; Weisenberg, Elliot; Weldon-Linne, C. Michael; Madoo, Omadath B.

doi:10.4158/ep.14.1.93

Cited by 14 publications

(5 citation statements)

References 6 publications

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“…However, some patients with non-secreting glomus tumours according to negative urinary tests may complain of typical symptoms of catecholamine secretion, such as flushes, sweats, or headaches (B. Verillaud, personal data). Moreover, in asymptomatic patients with an unsuspected pheochromocytoma, the inadvertent use of vasoconstrictors such as ergots or pseudoephedrine has been shown to provoke severe headaches and, sometimes, posterior reversible encephalopathy syndrome (14) or cardiac failure (15). In our second patient, the use of nasal decongestant could have interacted with a minimal undetected catecholamine secretion to increase the susceptibility to RCVS.…”

Section: Discussionmentioning

confidence: 99%

Reversible cerebral vasoconstriction syndrome in two patients with a carotid glomus tumour

et al. 2010

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We report two patients with reversible cerebral vasoconstriction syndrome (RCVS) and carotid glomus tumour. The first patient presented with multiple thunderclap headaches. Cervical and cerebral magnetic resonance imaging showed diffuse cerebral vasoconstriction on magnetic resonance angiogram (MRA) and a carotid glomus tumour. The second patient presented with a cervical mass and was diagnosed with a non-secreting paraganglioma of the carotid body. Surgery with pre-operative angiography was followed by thunderclap headaches and MRA showed segmental cerebral vasoconstriction. Both patients were treated with nimodipine and headaches stopped. Both had normal cerebral arteries on the control MRA at 3 months. These two cases suggest that a paraganglioma may increase the susceptibility to develop RCVS. As a consequence, patients with RCVS should be investigated for a carotid glomus tumour, and patients with paraganglioma reporting severe headaches should have a cerebral MRA in order to rule out cerebral vasoconstriction.

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Section: Discussionmentioning

confidence: 99%

Reversible cerebral vasoconstriction syndrome in two patients with a carotid glomus tumour

et al. 2010

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“…Our patient had global hypokinesis that has rarely been observed in patients with pheochromocytoma 11 12. Autopsy findings in patients with pheochromocytoma and cardiomyopathy demonstrate multifocal myocarditis and replacement fibrosis with mixed inflammatory cells and contraction band necrosis 4 13 14. The interstitial mononuclear inflammation seen on autopsy is distinct from the polymononuclear inflammation seen in ischaemic cardiomyopathy.…”

Section: Discussionmentioning

confidence: 62%

Pheochromocytoma presenting as acute decompensated heart failure reversed with medical therapy

Mulla

Marik²

2012

BMJ Case Reports

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A 26-year-old woman presented to hospital with acute chest pain, hypertension, tachycardia and an elevated serum creatinine. She developed respiratory distress requiring endotracheal intubation and mechanical ventilation. She progressed to multiorgan failure due to decompensated congestive heart failure. Echocardiography demonstrated global hypokinesis and an ejection fraction of <10%. Her cardiac function improved with fluid resuscitation and β blockade, and she was eventually discharged home. She was readmitted a few days later with pancreatitis after presenting with nausea, abdominal pain and hypertension. During hospitalisation she had paroxysms of headache, nausea and diaphoresis associated with hypertension and tachycardia. A CT scan of her abdomen revealed an adrenal mass and serum metanephrine studies confirmed the diagnosis of pheochromocytoma. After fluid resuscitation and sympathetic blockade her ejection fraction improved to 55%. The patient underwent an uneventful adrenalectomy and made a complete recovery.

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“…It can occur spontaneously, due to trauma, or be triggered by medications, including β-adrenergic receptor blockers, sympathomimetics (e.g., pseudoephedrine, ephedrine), dopamine receptor antagonists, opioid analgesics, neurotransmitter reuptake blockers, and peptide and steroid hormones (e.g., glucagon, adrenocorticotrophic hormone, corticosteroids). 4 , 7 The clinical presentation of a pheochromocytoma crisis ranges from severe hypertension to circulatory failure and shock.…”

Section: Discussionmentioning

confidence: 99%

Cardiomyopathy caused by a pheochromocytoma crisis in a 66-year-old woman

Jeyakumar,

Segal,

Kumachev

2024

CMAJ

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Hypertensive Crisis, Catecholamine Cardiomyopathy, and Death Associated with Pseudoephedrine use in a Patient with Pheochromocytoma

Cited by 14 publications

References 6 publications

Reversible cerebral vasoconstriction syndrome in two patients with a carotid glomus tumour

Reversible cerebral vasoconstriction syndrome in two patients with a carotid glomus tumour

Pheochromocytoma presenting as acute decompensated heart failure reversed with medical therapy

Cardiomyopathy caused by a pheochromocytoma crisis in a 66-year-old woman

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