Résumé
A 77-year-old man was admitted for aortic valve replacement and combined coronary bypass grafting. Grossly, labile arterial pressures were demonstrated on anesthetic induction prompting cancellation and Intensive Care Unit transfer. Urine analysis identified high normetadrenaline/creatinine ratio, plasma metanephrine, and plasma normetanephrine. A left adrenal lesion on computed tomography scan collectively indicated pheochromocytoma. Laparoscopic adrenalectomy was prioritized at multidisciplinary team before cardiac surgery. Vague symptoms of pheochromocytoma pose a diagnostic problem, being often attributed to common/co-existing pathology. The blood pressure instability on anesthetic required precise control, multidisciplinary input, and awareness of possible diagnosis as a routine intervention for hypotension may have been fatal in view of underlying cardiac pathology.
Résumé
Se realizó un estudio descriptivo y prospectivo de 117 pacientes ingresados en la Unidad de Cuidados Intensivos del Hospital Victoria de Santa Lucía por presentar crisis hipertensivas, desde enero hasta octubre de 2008, a fin de caracterizarles según variables clinicoepidemiológicas (edad, sexo, así como antecedentes patológicos personales y familiares, entre otras). Se halló que los malos hábitos dietéticos y los estilos de vida inadecuados favorecieron el descontrol de la tensión arterial, de manera que los cuidados y labor educativa de enfermería fueron determinantes en la disminución de los graves efectos ejercidos por los factores de riesgo encontrados.
A descriptive and prospective study was carried out in 117 patients hospitalised in the Intensive Care Unit of Victoria Hospital in Santa Lucia due to hypertensive crisis, from January to October, 2008, aimed at characterize them according to clinical epidemiological variables (age, sex, as well as personal and family backgrounds, among others). It was found that the bad dietary habits and inappropriate life styles favoured the uncontrolled blood pressure so that care and nursing educative work were determinant in decreasing the severe effects exerted by the risk factors found.