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(Chest. 2007;131:290-293.)
© 2007 American College of Chest Physicians

Small Cell Lung Cancer Presenting as a Paraneoplastic Syndrome Characterized by Recurrent Episodic Hypotension and Bradycardia*

Case Report

Mike G. Martin, MD; Amer K. Ardati, MD; Shannon M. Dunlay, MD; Amy P. Abernethy, MD and Michael A. Blazing, MD

* From the Departments of Internal Medicine (Drs. Martin, Ardati, and Dunlay), Hematology and Oncology (Dr. Abernethy), and Cardiology (Dr. Blazing), Duke University Medical Center, Durham, NC.

Correspondence to: Mike G. Martin, MD, Duke University, 1322 Arnette Ave, Durham, NC 27707; e-mail: marti157{at}mc.duke.edu

A 56-year-old man presenting with a 6-month history of recurrent episodic hypotension and bradycardia was found to have limited-stage small cell lung cancer. During both quiescence and episodes of hemodynamic embarrassment, extensive evaluations were conducted. Possible explanations included the following: intermittent great vessel obstruction; baroreceptor failure/hypersensitivity; and autonomic dysfunction. His clinical course favored an antibody-negative dysautonomic paraneoplastic syndrome.

Key Words: critical care • hypotension • lung cancer






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Copyright © 2007 by the American College of Chest Physicians.