TYK318
Unexpected sustained intraoperative hypertension may be due to:
a) Thyroid storm
b) Pheochromocytoma
c) Malignant hyperthermia
d) Autonomic hyperreflexia
e) Pre-eclampsia
f) All of the above
Answer
Answer f. Pheochromocytoma mimics many conditions and may present during manipulation of the bladder (Foley catheter placement) or during an unrelated surgical procedure. Unexplained sustained hypertension should prompt a widening of the diagnosis and aggressive treatment. A study of modern perioperative complications associated with pheochromocytoma noted that in patients who died, only one anti-hypertensive agent (without alpha-blockade) was used, and four of five deaths were associated with pregnancy (hypertension possibly confused for pre-eclampsia) or hysterectomy (Hariskov J Anaesthesiol Clin Pharmacol (2013) 29(1): 41–46).
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.