Department of Hypertension, Institute of Cardiology, Warsaw, Poland.
J Hypertens. 2011 Nov;29(11):2049-60. doi: 10.1097/HJH.0b013e32834a4ce9.
Clinical expression of phaeochromocytoma may involve numerous cardiovascular manifestations, but usually presents as sustained or paroxysmal hypertension associated with other signs and symptoms of catecholamine excess. Most of the life-threatening cardiovascular manifestations of phaeochromocytoma, such as hypertensive emergencies, result from a rapid and massive release of catecholamines from the tumour. More rarely, patients with phaeochromocytoma present with low blood pressure or even shock that may then precede multisystem crisis. Sinus tachycardia, with palpitations as the presenting symptom, is the most prevalent abnormality of cardiac rhythm in phaeochromocytoma, but tumours can also be associated with more serious ventricular arrhythmias or conduction disturbances. Reversible dilated or hypertrophic cardiomyopathy are well established cardiac manifestations of phaeochromocytoma, with more recent attention to an increasing number of cases with Takotsubo cardiomyopathy. This review provides an update on the cause, clinical presentation and treatment of the cardiovascular manifestations of phaeochromocytoma. As the cardiovascular complications of phaeochromocytoma can be life-threatening, all patients who present with manifestations that even remotely suggest excessive catecholamine secretion should be screened for the disease.
嗜铬细胞瘤的临床表现可能涉及多种心血管表现，但通常表现为持续性或阵发性高血压，并伴有儿茶酚胺过多的其他体征和症状。嗜铬细胞瘤最具威胁生命的心血管表现，如高血压急症，是由于肿瘤中儿茶酚胺的快速和大量释放引起的。更罕见的是，嗜铬细胞瘤患者表现为低血压甚至休克，随后可能发生多系统危机。窦性心动过速，以心悸为首发症状，是嗜铬细胞瘤中最常见的心律失常异常，但肿瘤也可与更严重的室性心律失常或传导障碍相关。扩张型或肥厚型心肌病是嗜铬细胞瘤明确的心脏表现，最近越来越多的注意到越来越多的心肌梗死后心肌病病例。本文综述了嗜铬细胞瘤心血管表现的病因、临床表现和治疗。由于嗜铬细胞瘤的心血管并发症可能危及生命，因此所有表现出即使是轻微的儿茶酚胺分泌过多的患者都应筛查该疾病。
