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  Monday, 19 November 2018
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I am a 36 year old male 5'10" 240 lbs. I have been on lisinopril for stage 1 hypertension since I was 30 and have been able to maintain a healthy bp while on this medicine. About 2 months ago I started having episodes of what the ER has described as anxiety. Racing heart 150 to 180 beats per min, often elevated bp when this happens highest ever was 200/110, feels like whole body is buzzing, sweating, chest pain. ECG come back normal. All regular blood work comes back normal, sent home told to calm down. I have a family history of heart disease so consulted a cardiologist who agreed to run some tests on me. Had a left side heart cath to ck for blockage all clear no sign of disease, also checked kidneys at same time again no stenosis etc. Had more blood work and a 24 hr urine metanephrines test done. All blood work came back in normal ranges expect for Aldosterone which was 29 ng/dL ref range less than or equal to 28 ng/dl. and Renin which was 41.7 ng/ml/h ref range .25 to 5.82 ng/ml/h. Cortisol TSH CBC, Basic metabolic panels all normal. The urine test results were Metenphrines, 24 H Ur 131 mcg/24 h ref range 36-190. Normetanephrine 24 h Ur 550 mcg/24 h ref range 35-482. Metaneph, Total, 24 H ur was 681 mcg/24 h ref range 115 -695. Cardiologist suspects a pheochromocytoma and is sending me for a ct scan of abdomen and pelvis. Needless to say Im worried. Would you conclude the same or recommend a different direction of investigation?

Do you happen to know the amount of creatinine in the 24 hour urine to judge the completeness of this collection?

In order to comment more fully, It would be much preferred to attach the actual lab result form that you are referring to after removing or obscuring your personal information.

Dr. Jordan Weinstein
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