Iatrogenous Pheochromocytoma

Report:

Sinus tachycardia 148 -160/min

VEBs

Frequent

Multiform

Bigeminal

Couplets

Run of 4 (VT)

Comment:

The almost six fold rise in the systolic BP was a surprise. Once the patient survived the effects of the generous dose of adrenaline (a dose normally used in cardiac arrest), she was started on a slow infusion of noradrenaline designed to keep the mean BP 60-70 mmHg.

Noradrenaline has the advantage of lesser chronotropic and metabolic effects in this setting. Fears that it may cause renal shutdown have not been realised and it has regained, after many years in disrepute, its rightful place in treatment of septic shock118.

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