Choisne C, Cottin Y, André F, Arnould L, Cougard P, Michel F, Viard H, Louis P, Wolf J E
Centre de Cardiologie Clinique et Interventionnelle, CHU Dijon.
Ann Cardiol Angeiol (Paris). 1994 Jun;43(6):331-4.
The diagnosis of pheochromocytoma is usually considered in the presence of permanent hypertension with exacerbations. However, pheochromocytoma may be responsible for a varied range of adrenergic symptomatology and hemodynamic equilibrium may be threatened by the spontaneous or induced massive release of pressor amines. Three cases form the basis of a description of unusual situations: acute pulmonary edema, acute circulatory failure and myocardial infarction with normal coronary vessels. The divercity and severity of these clinical situations are such that the possibility should always be suspected when confronted by any cardiomyopathy without obvious etiology, in particular in a hypertensive patient. The only treatment remains ablation of the tumour and diagnosis as an emergency is based, apart from history, on ultrasonography and/or abdominal CT scan and assay of urinary catecholamine derivative levels, which can be obtained within a few hours.
嗜铬细胞瘤的诊断通常在持续性高血压伴有病情加重时予以考虑。然而，嗜铬细胞瘤可能导致多种肾上腺素能症状，且血压平衡可能因升压胺的自发或诱发性大量释放而受到威胁。本文基于三个病例描述了一些不寻常的情况：急性肺水肿、急性循环衰竭以及冠状动脉正常的心肌梗死。这些临床情况的多样性和严重性使得在面对任何无明显病因的心肌病时，尤其是高血压患者，都应始终怀疑有嗜铬细胞瘤的可能性。唯一的治疗方法是切除肿瘤，而作为急诊的诊断，除病史外，还基于超声检查和/或腹部CT扫描以及尿儿茶酚胺衍生物水平的检测，这些检测结果可在数小时内获得。
