Demers Gerard, Portouw Steve
Emergency Department, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134-5000, USA.
J Emerg Trauma Shock. 2012 Apr;5(2):190-2. doi: 10.4103/0974-2700.96495.
Paragangliomas, extra-adrenal pheochromocytomas, are rare and classically associated with sustained or paroxysmal hypertension, headache, perspiration, palpitations, and anxiety. A 49-year-old male, parachute instructor, likely developed a hypertensive emergency when deploying his parachute leading to a myocardial infarction. A para-aortic tumor was incidentally discovered during the patient's emergency department work-up and was eventually surgically resected. He had no evidence of coronary disease during his evaluation. This case shows that a myocardial infarction may be the initial manifestation of these neuroendocrine tumors. Hypertensive emergency, much less elevated blood pressure may not be present at time of presentation.
副神经节瘤，即肾上腺外嗜铬细胞瘤，较为罕见，典型表现为持续性或阵发性高血压、头痛、出汗、心悸和焦虑。一名49岁的男性跳伞教练在跳伞时可能引发了高血压急症，进而导致心肌梗死。在患者急诊检查期间偶然发现了一个主动脉旁肿瘤，最终通过手术切除。在评估过程中，他没有冠心病的证据。该病例表明，心肌梗死可能是这些神经内分泌肿瘤的初始表现。高血压急症，甚至在就诊时可能并无血压升高的情况。
