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A 34-year-old woman presents with a chief complaint of what she calls “rushes,” intermittent episodes of sweating, headaches, and palpitations lasting for a few minutes and occurring sporadically every few days. These episodes can occur at any time of day and have sometimes awakened her from sleep. She notes that exercise may provoke her symptoms. Past medical history is significant for newly diagnosed hypertension. Her physical exam is remarkable only for hypertension, with a blood pressure of 165/100 mmHg. Her biochemical workup reveals an elevated 24-hour urine metanephrine (1163 mcg/day; normal <400 mcg/day). A dedicated adrenal protocol CT scan shows a 4-cm mass in the right adrenal gland.

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Intermittent Episodes of Sweating, Palpitations, and Hypertension

  • 章节

  • 发表日期：

    2026年

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  • Eugene J. Park,
  • Masha J. Livhits,
  • Areg Grigorian,
  • Michael W. Yeh

摘要

A 34-year-old woman presents with a chief complaint of what she calls “rushes,” intermittent episodes of sweating, headaches, and palpitations lasting for a few minutes and occurring sporadically every few days. These episodes can occur at any time of day and have sometimes awakened her from sleep. She notes that exercise may provoke her symptoms. Past medical history is significant for newly diagnosed hypertension. Her physical exam is remarkable only for hypertension, with a blood pressure of 165/100 mmHg. Her biochemical workup reveals an elevated 24-hour urine metanephrine (1163 mcg/day; normal <400 mcg/day). A dedicated adrenal protocol CT scan shows a 4-cm mass in the right adrenal gland.