Lopes H F, Silva H B, Frimm C de C, Bortolotto L A, Belotti G, Pileggi F
Instituto do Coração do Hospital das Clínicas - FMUSP.
Arq Bras Cardiol. 1995 Aug;65(2):167-9.
A 24 year-old man was admitted with hypertensive crises and diagnosis hypothesis of neurofibromathosis and pheochromocytoma with blood pressure of 150 x 110mmHg and in use of anti-hypertensive drugs. The electrocardiogram (EKG) showed left ventricle hypertrophy. An echocardiogram showed interventricular septum (IVS) thickness of 16mm, posterior wall (PW) thickness of 11mm (ratio IVS/PW was 1.4). Diastolic ventricular diameter was 39mm with gradient of 52mmHg and mild mitral-valve murmur by pulsate Doppler. Increased vanillylmandelic acid and metanephrines in a 24-hour sample of urine has confirmed diagnosis of pheochromocytoma within was localized by 131I metaiodobenzyl-guanidine scan and computerized axial tomography. The patient was submitted to right adrenalectomy. Blood pressure was normalized. Evaluation an year later revealed a healthy man with normal laboratory exams, EKG and echocardiogram. It seems that the hypertrophy was consequence of the hypertension and pheochromocytoma, was not hypertrophic cardiomyopathy.
一名24岁男性因高血压危象入院，诊断假设为神经纤维瘤病和嗜铬细胞瘤，血压为150×110mmHg，正在使用抗高血压药物。心电图（EKG）显示左心室肥厚。超声心动图显示室间隔（IVS）厚度为16mm，后壁（PW）厚度为11mm（IVS/PW比值为1.4）。舒张期心室直径为39mm，压差为52mmHg，脉冲多普勒显示轻度二尖瓣杂音。24小时尿样中香草扁桃酸和甲氧基肾上腺素增加，证实了嗜铬细胞瘤的诊断，通过131I间碘苄胍扫描和计算机断层扫描定位。患者接受了右肾上腺切除术。血压恢复正常。一年后的评估显示该男子健康，实验室检查、心电图和超声心动图均正常。看来这种肥厚是高血压和嗜铬细胞瘤的结果，而非肥厚型心肌病。
