I am a 39 y.o. female with sarcoidosis, MVP, and fibromyalgia. I have had sinus tachycardia since the onset of Sarcoidosis in 1989. I started having a constant pressure in my head in May 2000, and when I attempt to do any type of exertional exercise I get a throbbing headache, and a heart rate of 180 within 2 minutes. I am currently off work on disability due to the h/a's and severe fatigue. My resting heart rate stays around 110 without meds, and around 100 with Toprol 25 mg (1/2 tab). I did have a stress test recently, and the Dr. terminated it at 3 1/2 min. due to the tachycardia and my symptoms. I have a very poor exercise tolerance, and it takes about an hour to recover from the headaches after exercising. The cardiologist states that I had no ischemic EKG changes, but that he thinks I should be worked up for a pheochromocytoma. He also wants me to increase the Toprol to 25 mg 2 x day, but I feel even more tired, and occasionally dizzy with that. He wants my Internist to do the Pheo workup, and I also am waiting to see a neurologist next month. Do you think this sounds like a pheochromocytoma, or do you have any other ideas? Thanks!
Well pheochromocytoma is in the differential diagnosis of tachycardia and high blood pressure but it is rather rare. I would agree that you should be evaluated as it is rather a simple test - urine colection and blood test. Other potential causes include inappropriate sinus tachycardia, postural orthostatic hypotention (POTs) and deconditioning.
I'm in pretty much the same situation and I've had the blood test for a pheo. I'd kinda disagree that those tests are simple cuz I test positive on catecholamines, VMA and nor/metanephrines but nobody can find a tumour. Stress can probably throw the tests I would guess. And equally I know many others with a negatie test who ended up having a pheo -- they can be intermittent releases or hormones.
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