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Phaeochromocytoma—a presentation mimicking malignant hyperthermia
Author(s) -
CROWLEY K. J.,
CUNNINGHAM A. J.,
CONROY B.,
O'CONNELL P. R.,
COLLINS P. G.
Publication year - 1988
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1988.tb05703.x
Subject(s) - medicine , malignant hyperthermia , hyperthermia , propranolol , tachycardia , presentation (obstetrics) , respiratory acidosis , anesthesia , metabolic acidosis , acidosis , ventricular tachycardia , cardiology , surgery
Summary A 52‐year‐old apparently healthy, normotensive woman who presented for elective cholecystectomy experienced intra‐operative hypertension and tachycardia, which were controlled by propranolol. Oesophageal temperature increased, there was a metabolic and respiratory acidosis with hypoxaemia, and malignant hyperthermia was diagnosed. Severe cardiogenic pulmonary oedema ensued, and was treated with intravenous glyceryl trinitrate. Ventricular fibrillation caused cardiac arrest, and this was treated successfully. Postoperatively a phaeochromocytoma was discovered, and removed at a subsequent operation. The case illustrates the similarities in presentation of malignant hyperthermia and phaeochromocytoma, and the possibility that misdiagnosis may exacerbate the crisis.