Sammanfattning
This case report describes a 78-year-old woman who presented to the emergency department with acute dyspnea, sweating, nausea and tachycardia. In the emergency room blood pressure measurements
showed an unusual pattern of periodic alternating hypertension and hypotension. Investigation revealed the presence of a pheochromocytoma in the right adrenal gland and the patient was treated with alfa-
adrenergic blockade and fluid repletion. This treatment reduced the episodes of fluctuant blood pressure after several days of treatment but it was only after the surgical treatment that the patient became free of
symptoms. Although paroxysmal hypertension and orthostatic hypotension is well recognized in pheochromocytoma, the type of periodic changes of blood pressure which occurred in our case is distinctly unusual.
Possible mechanisms which lead to this phenomenon are discussed.