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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Adrenergic storm | 2/2 | https://en.wikipedia.org/wiki/Adrenergic_storm | reference | science, encyclopedia | 2026-05-05T07:25:52.151132+00:00 | kb-cron |
=== Differential diagnosis === Because the adrenergic storm overlaps with so many other similar conditions, such as hypertensive crises, stimulant intoxication or overdose, or even panic attack, and because the treatments for these overlapping conditions are largely alike, it is not necessary to obtain a differential and definitive diagnosis before initiating treatment. However, analysis of the patient's medical history, checked against the possible causes of the adrenergic storm such as those above, should be done, because some adrenergic storms can be caused by serious underlying conditions. If a patient has an adrenergic storm and all or most of the other factors are ruled out, the adrenergic storm could lead to the discovery of a pheochromocytoma, which can become malignant. However, not all cases of adrenergic storm have an identifiable cause. Serotonin syndrome, in which an excess of serotonin in the synapses causes a similar crisis of hypertension and mental confusion, could be confused with an adrenergic storm. Serotonin, being a tryptamine (non-catecholamine) involved in higher brain functions, can cause dangerous hypertension and tachycardia from its effects on the sympathetic nervous system. Symptoms caused by excessive adrenergic signalling can occur alongside those of serotonergic signalling. Abnormal echocardiograms or chest pain are indicative of adrenergic storm. On the other hand, uncontrollable slow, rhythmic, or jerky movements, contractions and tension—often in every part of the body, dangerously high fever, eye rolling, and bruxism are more indicative of serotonin syndrome.
== Treatment == If there is evidence of overdose or it is suspected, the patient should be given gastric lavage, activated charcoal, or both; this could make the difference between life and death in a close situation. It can however aggravate the patient which should be taken into account. The first-line treatments are diazepam and a non-selective beta blocker; other antihypertensive drugs may also be used. It is important to note that not all benzodiazepines and beta blockers are safe to use in an adrenergic storm; for instance, alprazolam and propranolol; alprazolam weakly agonizes dopamine receptors and causes catecholamine release while propranolol mildly promotes some catecholamine release – each worsening the condition. Antipsychotics are also used to treat the psychiatric symptoms such as aggression, agitation, psychosis, paranoia, or anxiety. Originally, the use of antipsychotics was discouraged because of their potential to prolong the QT interval; however, newer research has revealed that their careful use does not carry the potential for any significant side effects and today their judicious use is encouraged. Adrenergic storms are often idiopathic in nature; however if there is an underlying condition, then that must be addressed after bringing the heart rate and blood pressure down.
== See also == Adrenal crisis Paroxysmal sympathetic hyperactivity Sympathomimetic drug Takotsubo cardiomyopathy
== References ==