Management of Hypertension in Intrapericardial Paraganglioma
Functioning paraganglioma is extra-adrenal catecholamine-secreting tumours that may cause secondary hypertension. Primary intrapericardial paragangliomas are very rare and are located adjacent to the great vessels or heart, typically near the left atrium. These tumours are an exceptionally uncommon...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | International Journal of Hypertension |
| Online Access: | http://dx.doi.org/10.1155/2014/812598 |
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| author | Nicola Rotolo Andrea Imperatori Alessandro Bacuzzi Valentina Conti Massimo Castiglioni Lorenzo Dominioni |
| author_facet | Nicola Rotolo Andrea Imperatori Alessandro Bacuzzi Valentina Conti Massimo Castiglioni Lorenzo Dominioni |
| author_sort | Nicola Rotolo |
| collection | DOAJ |
| description | Functioning paraganglioma is extra-adrenal catecholamine-secreting tumours that may cause secondary hypertension. Primary intrapericardial paragangliomas are very rare and are located adjacent to the great vessels or heart, typically near the left atrium. These tumours are an exceptionally uncommon finding during the investigation of refractory hypertension. However, in recent years, intrapericardial paragangliomas have been diagnosed incidentally with increased frequency, due to the extensive use of radiologic chest imaging. The mainstay of treatment of functioning intrapericardial paraganglioma is surgical removal, which usually achieves blood pressure normalization. Due to the locations of these tumours, the surgical approach is through a median sternotomy or posterolateral thoracotomy, and manipulation-induced catecholamine release may cause paroxysmal hypertension. Typically in these patients, blood pressure fluctuates dramatically intra- and post-operatively, increasing the risk of cardiovascular complications. We review here the current modalities of perioperative fluid and hypotensive drug administration in the setting of surgery for functioning intrapericardial paraganglioma and discuss the recently proposed paradigm shift that omits preoperative preparation. |
| format | Article |
| id | doaj-art-6dec3b3037f04d2387152f93ef10314c |
| institution | Kabale University |
| issn | 2090-0384 2090-0392 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Hypertension |
| spelling | doaj-art-6dec3b3037f04d2387152f93ef10314c2025-02-03T06:07:12ZengWileyInternational Journal of Hypertension2090-03842090-03922014-01-01201410.1155/2014/812598812598Management of Hypertension in Intrapericardial ParagangliomaNicola Rotolo0Andrea Imperatori1Alessandro Bacuzzi2Valentina Conti3Massimo Castiglioni4Lorenzo Dominioni5Center for Thoracic Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Via Guicciardini 9, 21100 Varese, ItalyCenter for Thoracic Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Via Guicciardini 9, 21100 Varese, ItalyDepartment of Anaesthesiology, Ospedale di Circolo, Via Guicciardini 9, 21100 Varese, ItalyCenter for Thoracic Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Via Guicciardini 9, 21100 Varese, ItalyCenter for Thoracic Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Via Guicciardini 9, 21100 Varese, ItalyCenter for Thoracic Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Via Guicciardini 9, 21100 Varese, ItalyFunctioning paraganglioma is extra-adrenal catecholamine-secreting tumours that may cause secondary hypertension. Primary intrapericardial paragangliomas are very rare and are located adjacent to the great vessels or heart, typically near the left atrium. These tumours are an exceptionally uncommon finding during the investigation of refractory hypertension. However, in recent years, intrapericardial paragangliomas have been diagnosed incidentally with increased frequency, due to the extensive use of radiologic chest imaging. The mainstay of treatment of functioning intrapericardial paraganglioma is surgical removal, which usually achieves blood pressure normalization. Due to the locations of these tumours, the surgical approach is through a median sternotomy or posterolateral thoracotomy, and manipulation-induced catecholamine release may cause paroxysmal hypertension. Typically in these patients, blood pressure fluctuates dramatically intra- and post-operatively, increasing the risk of cardiovascular complications. We review here the current modalities of perioperative fluid and hypotensive drug administration in the setting of surgery for functioning intrapericardial paraganglioma and discuss the recently proposed paradigm shift that omits preoperative preparation.http://dx.doi.org/10.1155/2014/812598 |
| spellingShingle | Nicola Rotolo Andrea Imperatori Alessandro Bacuzzi Valentina Conti Massimo Castiglioni Lorenzo Dominioni Management of Hypertension in Intrapericardial Paraganglioma International Journal of Hypertension |
| title | Management of Hypertension in Intrapericardial Paraganglioma |
| title_full | Management of Hypertension in Intrapericardial Paraganglioma |
| title_fullStr | Management of Hypertension in Intrapericardial Paraganglioma |
| title_full_unstemmed | Management of Hypertension in Intrapericardial Paraganglioma |
| title_short | Management of Hypertension in Intrapericardial Paraganglioma |
| title_sort | management of hypertension in intrapericardial paraganglioma |
| url | http://dx.doi.org/10.1155/2014/812598 |
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