Mulla Christopher M, Marik Paul Ellis
Department of Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA.
BMJ Case Rep. 2012 Jul 19;2012:bcr2012006319. doi: 10.1136/bcr-2012-006319.
A 26-year-old woman presented to hospital with acute chest pain, hypertension, tachycardia and an elevated serum creatinine. She developed respiratory distress requiring endotracheal intubation and mechanical ventilation. She progressed to multiorgan failure due to decompensated congestive heart failure. Echocardiography demonstrated global hypokinesis and an ejection fraction of <10%. Her cardiac function improved with fluid resuscitation and β blockade, and she was eventually discharged home. She was readmitted a few days later with pancreatitis after presenting with nausea, abdominal pain and hypertension. During hospitalisation she had paroxysms of headache, nausea and diaphoresis associated with hypertension and tachycardia. A CT scan of her abdomen revealed an adrenal mass and serum metanephrine studies confirmed the diagnosis of pheochromocytoma. After fluid resuscitation and sympathetic blockade her ejection fraction improved to 55%. The patient underwent an uneventful adrenalectomy and made a complete recovery.
一名26岁女性因急性胸痛、高血压、心动过速和血清肌酐升高入院。她出现呼吸窘迫，需要气管插管和机械通气。由于失代偿性充血性心力衰竭，她进展为多器官功能衰竭。超声心动图显示全心运动减弱，射血分数<10%。通过液体复苏和β受体阻滞剂治疗，她的心脏功能得到改善，最终出院回家。几天后，她因出现恶心、腹痛和高血压而再次入院，诊断为胰腺炎。住院期间，她出现与高血压和心动过速相关的阵发性头痛、恶心和多汗。腹部CT扫描显示肾上腺肿块，血清间甲肾上腺素检查确诊为嗜铬细胞瘤。经过液体复苏和交感神经阻滞，她的射血分数提高到55%。患者接受了顺利的肾上腺切除术，并完全康复。
