Cardiac Arrest due to Unsuspected pheochromocytoma Presenting during Gastric Polyp Operation / 대한마취과학회지

The anesthetic management of patient with pheochromocytoma is often difficult even when a clear-cut preoperative diagnosis has been made. We experienced a patient with a gastric polyp and an unsuspected pheochromocytoma which presented with transient hypertension during general anesthesia for an elective subtotal gastrectomy. The patient developed severe hypertension and arrhythmia leading to cardiac arrest just after the skin incision. This case illustrate the value of preoperative evaluation in a patient with transient hypertension.

Effects of Hypertension Induced by Norepinephrine and Sodium Chloride upon the Arteries and Various Organs of Rats

Histopathological effects due to elevation of blood pressure induced by norepinephrine and sodium chloride, and due to high cholesterol feeding were studied upon the arteries and various organs of rats for the evaluation of relationship between arteriosclerosis and hypertension. Blood pressure was generally elevated in all groups, but rose significantly, particularly in the groups receiving sodium chloride. This was especially abrupt at the end of 3 months. No particular gross nor histopathologic changes were found in the aorta, but variable alterations in the coronary and renal arteries including hypertrophic and proliferative changes were characteristically identified. Variable interesting changes of myocardium, kidneys and adrenal glands were also observed. The hypertrophic changes were especially due to hyalinosis in the vascular wall, and the proliferative changes in several cases were similiar to that noted in malignant hypertension. Induction of hypertension by norepinephrine and sodium chloride caused arterial changes such as hypertrophic changes, mainly hyalinosis, and proliferative and necrotizing changes especially in the renal and coronary arteries of rats.