| Paroxysmal hypertension, pheochromocytoma, and pregnancy. | |
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MedLine Citation:
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PMID: 12002199 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Hypertension is the most common medical complication of pregnancy. Pheochromocytoma in pregnancy is rare, and if unrecognized, can cause serious perinatal morbidity and mortality. METHODS: A patient with severe hypertension, postpartum pulmonary edema, and a recognized pheochromocytoma is described. RESULTS: Abdominal palpation after vaginal childbirth reproduced the diagnostic triad of hypertension, headaches, and palpitations. Magnetic resonance imaging established the correct diagnosis before biochemical confirmation of excess catecholamine production. The patient responded to alpha-adrenergic receptor blockade with control of her severe hypertension and clearing of pulmonary edema. The best time to diagnose a pheochromocytoma is before delivery because vaginal childbirth stimulates the release of lethal amounts of catecholamines. CONCLUSIONS: The physician who delivers babies must distinguish between labile hypertension and paroxysmal hypertension. Most experts believe that a spontaneous vaginal delivery is contraindicated when the patient has a pheochromocytoma. Postpartum pulmonary edema associated with a pheochromocytoma is unusual. The profound pressor response elicited by palpation of the postpartum abdomen, the failure of medications usually effective in the treatment of a hypertensive crisis, and the use of magnetic resonance imaging to confirm a functioning adrenal adenoma are the features unique to this case. |
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Authors:
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David J Lyman |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The Journal of the American Board of Family Practice / American Board of Family Practice Volume: 15 ISSN: 0893-8652 ISO Abbreviation: J Am Board Fam Pract Publication Date: 2002 Mar-Apr |
Date Detail:
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Created Date: 2002-05-10 Completed Date: 2002-09-12 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8807505 Medline TA: J Am Board Fam Pract Country: United States |
Other Details:
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Languages: eng Pagination: 153-8 Citation Subset: IM |
Affiliation:
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Department of Family Medicine, University of Tennessee, Jackson, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Gland Neoplasms
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complications,
diagnosis*,
surgery Adrenalectomy Adrenergic alpha-Antagonists / therapeutic use Adult Female Humans Hypertension / complications, diagnosis*, drug therapy Magnetic Resonance Imaging Pheochromocytoma / complications, diagnosis*, surgery Pregnancy Pregnancy Complications, Cardiovascular / diagnosis*, therapy Pregnancy Complications, Neoplastic / diagnosis*, surgery, therapy Pulmonary Edema / complications, drug therapy United States |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic alpha-Antagonists |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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