Direct Arterial Pressure, Heart Rate, and Electrocardiogram in Unrestricted Patients Before and After Removal of a Phaeochromocyoma

Direct arterial pressure and electrocardiogram have been recorded continuously over a period of 24 hours in three unrestricted patients before and after removal of a phaeochromocytoma. During waking hours the arterial pressure behaved quite differently in each case: one patient maintained sustained hypertension without any paroxysmal rises or falls; a second patient showed a very labile arterial pressure and developed attacks of fear and trembling with palpitations associated with arterial hypotension, tachycardia and arrhythmias; whilst a third patient showed labile arterial pressure and attacks of fear and palpitations associated with very high levels of both systolic and diastolic blood pressure. In all three patients during sleep the arterial pressure was more stable than during waking but in two cases the diastolic and mean arterial pressures did not fall below waking levels; in the third case, a small fall was observed. With removal of the tumour, the arterial pressure returned to normal in two patients with a significant fall during sleep; the third patient remained hypertensive five years after surgery despite successful removal of the tumour.