Disorders induced by pheochromocytoma in the cardiovascular system. A therapeutic approach

The diagnosis of pheochromocytoms is still made only post mortem in a high percentage of the cases. It is important to know both the diversity of clinical forms (of the 16 cases investigated 13 (80%) presented permanent AH, of which 12 cases with paroxysmal attacks, followed by collapse only in one case, and 3 (20%) with paroxysmal AH on a normotensive background) and the severity of cardiovascular accidents, which increases twofold during crises (arrhythmias, left ventricular failure, coronary insufficiency, cerebrovascular strokes, secondary adrenalinic shocks). These complications are preceded by the "alarm syndrome". The preoperatory treatment is associated: blocking of adrenergic alpha-receptors and beta-receptors; correction of hypovolemia, also applied during the surgical phase I (until the venous ligature is made and the tumor excised) under continuous monitoring (ECG, ABP and central venous pressure). In phase II vasoplegin should be promptly corrected by nor. E+E, and corticoids.