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Pheochromocytoma Crisis, Cardiomyopathy, and Hemodynamic Collapse*

Jorge R. Kizer, MD, MSc; Lauren S. Koniaris, MD; Jeffrey D. Edelman, MD, FCCP; Martin G. St. John Sutton, MBBS
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*From the Cardiovascular (Drs. Kizer and St. John Sutton) and Pulmonary and Critical Care Divisions (Drs. Koniaris and Edelman), Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, PA.

Correspondence to: Jorge R. Kizer, MD, MSc, Cardiovascular Division, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104; e-mail: kizer@mail.med.upenn.edu



Chest. 2000;118(4):1221-1223. doi:10.1378/chest.118.4.1221
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Pheochromocytoma is a notorious clinical entity. Although suspicion is aroused by severe hypertension in young patients, this sign is often absent. We present a case in which early absence of hypertension and nonspecific signs and symptoms led to failure of prompt diagnosis. The delay proved fatal when the patient developed fulminant pheochromocytoma crisis. This case illustrates a variety of clinical features seen from the vantage of the evolution of the disease as it went unrecognized. The patient’s course underscores the importance of familiarity with the gamut of manifestations for timely diagnosis, and the priority of the latter given the looming risk of overwhelming complications.

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