Pheochromocytoma Crisis
Report:
Sinus rhythm 54/min
Short PR interval 0.10”
Global T wave inversion
Prolonged QT interval 0.56”
Qtc for 54/min = 0.47”
Comment:
The striking T wave inversion, like that caused by its ‘cerebral’ counterpart, is caused by a catecholamine surge. The presentation with profound hypotension is less common than a hypertensive crisis, but is well known.
It would be tempting to ascribe the short PR interval to catecholamine effect on the AV node, but this would be unexpected in the absence of tachycardia. Further, it persisted a month later, despite propranolol/phenoxybenzamine therapy (189a below). The patient probably had an unrelated Lown-Ganong-Levine conduction.
A left adrenal, predominantly adrenaline-secreting tumour was removed a month later; by then the ECG had substantially normalised.
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