A unique cardiovascular presentation of pheochromocytoma
We describe a unique presentation of a pheochromocytoma in a normotensive teenager, who presented with symptoms of headache, neck pain, and palpitations. Holter and event monitor tracings revealed intermittent junctional rhythm causing electromechanical dyssynchrony between atrial and ventricular co...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-02-01
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| Series: | SAGE Open Medical Case Reports |
| Online Access: | https://doi.org/10.1177/2050313X21994037 |
| _version_ | 1819297683899154432 |
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| author | William B Orr Riti Chokshi Georgeann Groh Jennifer N Avari Silva George F Van Hare Aarti S Dalal |
| author_facet | William B Orr Riti Chokshi Georgeann Groh Jennifer N Avari Silva George F Van Hare Aarti S Dalal |
| author_sort | William B Orr |
| collection | DOAJ |
| description | We describe a unique presentation of a pheochromocytoma in a normotensive teenager, who presented with symptoms of headache, neck pain, and palpitations. Holter and event monitor tracings revealed intermittent junctional rhythm causing electromechanical dyssynchrony between atrial and ventricular contraction resulting in reported symptoms. Exercise stress testing helped correlate symptomatic junctional rhythm events to episodic hypertension which led to the eventual diagnosis of pheochromocytoma. The exercise test provided insight into the physiologic coupling that the sympathetic and parasympathetic autonomic nervous systems have on the cardiovascular system during exercise and exaggerated hypertension. The patient was found to have MEN2A and partial adrenalectomy resulted in complete resolution of symptoms and arrhythmia. This unusual presentation illustrates the benefit of a comprehensive clinical evaluation, which led to the eventual diagnosis. |
| first_indexed | 2024-12-24T05:17:55Z |
| format | Article |
| id | doaj.art-8a712edbd7b8405494d5b7421ed8be8d |
| institution | Directory Open Access Journal |
| issn | 2050-313X |
| language | English |
| last_indexed | 2024-12-24T05:17:55Z |
| publishDate | 2021-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medical Case Reports |
| spelling | doaj.art-8a712edbd7b8405494d5b7421ed8be8d2022-12-21T17:13:32ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2021-02-01910.1177/2050313X21994037A unique cardiovascular presentation of pheochromocytomaWilliam B Orr0Riti Chokshi1Georgeann Groh2Jennifer N Avari Silva3George F Van Hare4Aarti S Dalal5Department of Pediatrics, Division of Pediatric, Division of Cardiology, Washington University School of Medicine, St. Louis, MO, USASaint Louis Children’s Hospital, St. Louis, MO, USADepartment of Pediatrics, Division of Pediatric, Division of Cardiology, Washington University School of Medicine, St. Louis, MO, USADepartment of Pediatrics, Division of Pediatric, Division of Cardiology, Washington University School of Medicine, St. Louis, MO, USADepartment of Pediatrics, Division of Pediatric, Division of Cardiology, Washington University School of Medicine, St. Louis, MO, USADepartment of Pediatrics, Division of Pediatric, Division of Cardiology, Washington University School of Medicine, St. Louis, MO, USAWe describe a unique presentation of a pheochromocytoma in a normotensive teenager, who presented with symptoms of headache, neck pain, and palpitations. Holter and event monitor tracings revealed intermittent junctional rhythm causing electromechanical dyssynchrony between atrial and ventricular contraction resulting in reported symptoms. Exercise stress testing helped correlate symptomatic junctional rhythm events to episodic hypertension which led to the eventual diagnosis of pheochromocytoma. The exercise test provided insight into the physiologic coupling that the sympathetic and parasympathetic autonomic nervous systems have on the cardiovascular system during exercise and exaggerated hypertension. The patient was found to have MEN2A and partial adrenalectomy resulted in complete resolution of symptoms and arrhythmia. This unusual presentation illustrates the benefit of a comprehensive clinical evaluation, which led to the eventual diagnosis.https://doi.org/10.1177/2050313X21994037 |
| spellingShingle | William B Orr Riti Chokshi Georgeann Groh Jennifer N Avari Silva George F Van Hare Aarti S Dalal A unique cardiovascular presentation of pheochromocytoma SAGE Open Medical Case Reports |
| title | A unique cardiovascular presentation of pheochromocytoma |
| title_full | A unique cardiovascular presentation of pheochromocytoma |
| title_fullStr | A unique cardiovascular presentation of pheochromocytoma |
| title_full_unstemmed | A unique cardiovascular presentation of pheochromocytoma |
| title_short | A unique cardiovascular presentation of pheochromocytoma |
| title_sort | unique cardiovascular presentation of pheochromocytoma |
| url | https://doi.org/10.1177/2050313X21994037 |
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