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Case Reports in Endocrinology
Volume 2011, Article ID 759523, 4 pages
http://dx.doi.org/10.1155/2011/759523
Case Report

Recurrent Urosepsis and Cardiogenic Shock in an Elderly Patient with Pheochromocytoma

Department of Endocrinology, Changi General Hospital, Singapore 529889

Received 5 June 2011; Accepted 6 July 2011

Academic Editors: K. Iida and R. Murray

Copyright © 2011 Joan Joo-Ching Khoo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pheochromocytomas are thought to be uncommon in the elderly. However, the prevalence is likely to be higher than reported, as older patients are less likely to be diagnosed due to absence of classical symptoms of sympathetic overactivity and confounding effects of aging, comorbidities, and medications. We describe a hypertensive elderly patient with incidentally diagnosed pheochromocytoma complicated by recurrent urosepsis, cardiomyopathy, and fatal myocardial infarction. Our case demonstrates that, in older hypertensive patients without classical symptoms, orthostatic hypotension and urinary retention, which are common in the elderly, may indicate catecholamine excess and that the deleterious cardiovascular consequences of catecholamine excess in the elderly are not prevented by pharmacological α- and β-blockade.