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Keywords:

  • adrenal gland;
  • pheochromocytoma;
  • arrhythmia;
  • hemodynamics;
  • hypertension;
  • magnetic resonance imaging

Abstract

Objective: To describe a case of atrioventricular block and syncope secondary to systemic hypertension in a dog with malignant pheochromocytoma.

Case Summary: A 13-year-old spayed female mixed-breed dog presented following an acute onset of collapse. The dog was hypertensive and had paradoxical high-grade second-degree atrioventricular block with concurrent syncope. Initial emergent therapy included a nitroprusside infusion for the systemic hypertension and vagolytic therapy for the bradyarrhythmia. A left adrenal mass was seen on abdominal ultrasound and was further characterized by MRI. Following medical stabilization with phenoxybenzamine and propantheline, a left adrenalectomy was performed. Histological diagnosis was consistent with a malignant pheochromocytoma. Following tumor removal there has been no further hypertension, atrioventricular block or syncope.

Unique information provided: This is the first documented case of a malignant pheochromocytoma presenting as syncope secondary to hypertension induced atrioventricular block.