Malignant phaeochromocytoma with severe constipation and myocardial necrosis.

Short, Ian; Padfield, P L

doi:10.1136/bmj.2.6039.793-a

Cited by 21 publications

(12 citation statements)

References 3 publications

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“…Giant negative T waves with QT prolongation have also been reported (Cheng and Bashour, 1975). The electrocardiographic changes of our patient and most of the reported cases have been reversible (Short and Redfield, 1976;Surawicz and Mangiardi, 1977). Although hypertension is the usual finding, pheochromocytoma attacks may be associated with hypotension (Delaney and Paritzky, 1964;Huston and Stewart, 1965;Moorhead et ad., 1966;Radtke et al, 1975).…”

Section: Discussionsupporting

confidence: 69%

“…Although hypertension is the usual finding, pheochromocytoma attacks may be associated with hypotension (Delaney and Paritzky, 1964;Huston and Stewart, 1965;Moorhead et ad., 1966;Radtke et al, 1975). It has also been suggested that in cases with hypotension, the beta-adrenergic effects of epinephrine dominate and cause hypotension rather than hypertension (Short and Redfield, 1976). Our case presents a different phenomenon.…”

Section: Discussionmentioning

confidence: 61%

“…Coronary arteries have been found to be normal in autopsy (Pelkonen and Pitkaenen, 1963). The excessive catecholamine release, excessive oxygen demand, toxic effects, and coronary spasm may be the cause of myocardial injury and infarction (Radtke et al, 1980;Short and Redfield, 1976). Cardiomyopathy and myocarditis may also be present in patients with pheochromocytoma (Allen et al, 1951;Armstrong et al, 1972; Wiswell and Crago, 1968), which may be generalized or focal (Scully and Neely, 1975 Wiswell and Crago, 1968).…”

Section: Discussionmentioning

confidence: 99%

“…Pheochromocytomas have recently been reported to be associated with myocardial injury and infarction, peripheral vascular ischemia, noncardiac pulmonary edema, and hypotension (Gupta, 1975;Pelkonen and Pitkaenen, 1963;Radtke et al, 1975;Scully and Neely, 1975;Short and Redfield, 1976;Williams and Braunwald, 1980).…”

Section: Introductionmentioning

confidence: 99%

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Unusual cardiovascular manifestations in a case of pheochromocytoma

Sheikhzadeh¹,

Fatourechi²,

Paydar³

et al. 1983

Clinical Cardiology

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Summary:A case of proven pheochromocytoma is reported of a patient who presented with attacks of apparent hypotension, pulmonary edema, and myocardial injury with typical ECG and enzyme change. In spite of unmeasurably low peripheral blood pressure recordings during the attack, central aortic pressure was well above 240/140 mmHg. A clinical shocklike state was in effect due to severe arterial vasoconstriction. The pulmonary artery pressure was 48/26 mmHg during attacks, wedge pressure was 26 mmHg, and cardiac index 1.8 liters/ min/m2. The coronary angiogram showed abnormal pooling of dye in the myocardial capillary network. It is concluded that: (1) Apparent hypotensive episodes in pheochromocytoma may be misleading and central arterial measurements may be needed to demonstrate the hypertensive crisis. (2) The abnormal coronary angiogram in our patient may be due to myocardial necrosis and damage to the intact arteriolar and microvascular system of the myocardium.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Unusual cardiovascular manifestations in a case of pheochromocytoma

Sheikhzadeh¹,

Fatourechi²,

Paydar³

et al. 1983

Clinical Cardiology

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“…It is not impossible that this complication is caused by an overactivity of the sympathetic nervous system [28,33]. The appearance of paralytic ileus has also been reported in patients with phaeochromocytoma [14,18,45]. Gastrointestinal bleeding from stress ulcers was one of the complications observed in patients with tetanus [17, 251.…”

Section: Sweatingmentioning

confidence: 95%

The involvement of the sympathetic nervous system in tetanus

1979

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Besides the characteristic disturbances of the motor nervous system symptoms indicating an overactivity of the sympathetic nervous system can complicate the course of severe cases of tetanus. These symptoms include fluctuating tachycardia and hypertension, electrocardiographic changes, sweating, constipation with development of paralytic ileus and metabolic disorders. These symptoms are comparable to these developing in patients with phaeochromocytoma. Elevated catecholamine levels in plasma and urine have been found in several patients with tetanus who developed these symptoms. The prolonged over-activity of the sympathetic nervous system is thought to contribute to the still considerably high mortality rate. Myocardial lesions observed at necropsy are comparable to those found in patients dying of phaeochromocytoma. These lesions are suggested to be associated with sudden death from arrhythmias or cardiac failure in patients with tetanus. For the protection of the organism against the overactivity of the sympathetic nervous system a treatment using the combination of beta-adrenergic receptor blocking agents and adrenergic neuron blocking agents has been introduced. A reduction of the mortality rate was achievable by this treatment. Experimental evidence is accumulating that the tetanus toxin affects not only the motor, but also the sympathetic and sensory neurons.

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Malignant phaeochromocytoma: Report of a case and a critical review

et al. 1982

British Journal of Surgery

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A right adrenal phaeochromocytoma is described in a 64-year-old man. Metastases to bone and subsequent death following cord compression occurred within 2 years of diagnosis. Twenty-seven cases in the English literature have been reviewed since 1968. In three of these, the pathological proof was unsatisfactory for the diagnosis of malignancy, and one further case was inadequately documented. The variation in incidence of malignancy found in large retrospective series may relate to inconsistency in pathological criteria, as well as to selective reporting of cases.

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Malignant phaeochromocytoma with severe constipation and myocardial necrosis.

Cited by 21 publications

References 3 publications

Unusual cardiovascular manifestations in a case of pheochromocytoma

Unusual cardiovascular manifestations in a case of pheochromocytoma

The involvement of the sympathetic nervous system in tetanus

Malignant phaeochromocytoma: Report of a case and a critical review

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