Paroxysmal Hypertension and Hypovolemia

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Abstract
CATECHOLAMINE release produces a clinical picture characterized by hypertension, anxiety, sweating and tachycardia. Blood volume is often reduced in pheochromocytoma,1 and hypovolemia has been implicated as a cause of the shock that occasionally complicates the preoperative or postoperative course.2 Essential hypertension, however, is not usually associated with signs of sympathoadrenal discharge or with reduced blood volume.3 , 4 Recently 3 patients were observed who exhibited paroxysmal elevation of blood pressure with many features suggesting catecholamine release. Despite intensive investigation no evidence for pheochromocytoma could be found. The development of shock in response to minimal stresses in all 3 patients suggests that they . . .