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Pathophysiology and Acute Management of Tachyarrhythmias in Pheochromocytoma: JACC Review Topic of the Week. [Review]

MedStar author(s):

Citation: Journal of the American College of Cardiology. 76(4):451-464, 2020 07 28.PMID: 32703516Institution: MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Patient Care Management/mt [Methods] | *Pheochromocytoma | *Tachycardia | Adrenal Gland Neoplasms/co [Complications] | Adrenal Gland Neoplasms/me [Metabolism] | Adrenal Gland Neoplasms/pa [Pathology] | Humans | Pheochromocytoma/co [Complications] | Pheochromocytoma/me [Metabolism] | Pheochromocytoma/pa [Pathology] | Tachycardia/et [Etiology] | Tachycardia/pp [Physiopathology] | Tachycardia/th [Therapy]Year: 2020 ISSN:

0735-1097

Name of journal: Journal of the American College of CardiologyAbstract: Pheochromocytomas, arising from chromaffin cells, produce catecholamines, epinephrine and norepinephrine. The tumor biochemical phenotype is defined by which of these exerts the greatest influence on the cardiovascular system when released into circulation in high amounts. Action on the heart and vasculature can cause potentially lethal arrhythmias, often in the setting of comorbid blood pressure derangements. In a review of electrocardiograms obtained on pheochromocytoma patients (n = 650) treated at our institution over the last decade, severe and refractory sinus tachycardia, atrial fibrillation, and ventricular tachycardia were found to be the most common or life-threatening catecholamine-induced tachyarrhythmias. These arrhythmias, arising from catecholamine excess rather than from a primary electrophysiologic substrate, require special considerations for treatment and complication avoidance. Understanding the synthesis and release of catecholamines, the adrenoceptors catecholamines bind to, and the cardiac and vascular response to epinephrine and norepinephrine underlies optimal management in catecholamine-induced tachyarrhythmias. Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.All authors: Haigney MC, Nazari MA, Pacak K, Rosenblum JS, Rosing DROriginally published: Journal of the American College of Cardiology. 76(4):451-464, 2020 Jul 28.Fiscal year: FY2021Digital Object Identifier:

https://dx.doi.org/10.1016/j.jacc.2020.04.080

Date added to catalog: 2020-09-02

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Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	32703516	Available		32703516

Pheochromocytomas, arising from chromaffin cells, produce catecholamines, epinephrine and norepinephrine. The tumor biochemical phenotype is defined by which of these exerts the greatest influence on the cardiovascular system when released into circulation in high amounts. Action on the heart and vasculature can cause potentially lethal arrhythmias, often in the setting of comorbid blood pressure derangements. In a review of electrocardiograms obtained on pheochromocytoma patients (n = 650) treated at our institution over the last decade, severe and refractory sinus tachycardia, atrial fibrillation, and ventricular tachycardia were found to be the most common or life-threatening catecholamine-induced tachyarrhythmias. These arrhythmias, arising from catecholamine excess rather than from a primary electrophysiologic substrate, require special considerations for treatment and complication avoidance. Understanding the synthesis and release of catecholamines, the adrenoceptors catecholamines bind to, and the cardiac and vascular response to epinephrine and norepinephrine underlies optimal management in catecholamine-induced tachyarrhythmias. Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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