This case begins with a gentleman who has high blood pressures incidentally discovered at a workplace health screening. While he should have the characteristic hypokalemic metabolic alkalosis of aldosteronoma, his presentation is designed to be confused by a concurrent infectious gastroenteritis, which produces a hypochloremic, hypokalemic metabolic alkalosis due to repeated vomiting. The patient receives conservative management for his uncomplicated gastroenteritis, and is provided initial antihypertensive treatment. After a few follow-up visits, his hypertension will prove difficult to control despite several antihypertensive medications. At this point, additional lab work will demonstrate clear hypokalemic metabolic alkalosis, suggestive of primary aldosteronism. Biochemical testing will confirm elevated aldosterone levels. Abdominal CT will demonstrate a unilateral adrenal lesion compatible with aldosteronoma, and adrenal vein sampling will confirm the lesion as the source. He will be referred to an appropriate surgical specialist (endocrine surgeon, urologist, surgical oncologist, etc.) for further surgical management/resection.