A 31-year-old woman has new-onset headaches and blood pressure elevation. She also notices that the symptoms come episodically and consist of palpitations, headache, anxiety, and marked blood pressure elevation. She undergoes a workup for secondary causes of hypertension, and is found to have elevated free catecholamines in her urine.For the above patient with systemic disease, select the most typical cardiovascular involvement.: (A) focal myocardial necrosis, (B) proximal aortitis, (C) endothelial plaques, (D) systolic scratchy sound
Answer is A. Focal myocardial necrosis and inflammatory cell infiltration caused by high circulating levels of catecholamines are seen in about 50% of patients who die with pheochromocytoma. Hypertension can further impair left ventricular function.