Pheochromocytoma, a rare cause of hypertension, is potentially fatal if left untreated. Definitive treatment is resection of the mass. Preoperative blockade is important to improve intraoperative hemodynamic stability and reduce morbidity during resection. Phenoxybenzamine, a non-selective alpha adrenergic blocker, has been widely used as preoperative blockade, but is unavailable in the Philippines. Terazosin, a selective alpha 1 antagonist and is widely available as treatment for benign prostatic hypertrophy, has been documented in reports as a suitable preoperative drug in reducing blood pressure in pheochromocytoma patients. The objective is to present four cases of Filipino pheochromocytoma patients who were treated with terazosin as first line preoperative blockade. Four Filipino patients from the Philippine General Hospital were diagnosed with pheochromocytoma based on biochemical and imaging studies. They were started on different doses of terazosin, the maximum dose as high as 4 mg per day. One patient experienced orthostatic hypotension at this dose, but was resolved after reducing the dose to 3 mg per day. A beta blocker (metoprolol on 3 cases, carvedilol) was added for reduction of the symptoms. One patient was also diagnosed with diabetic ketoacidosis, and was treated as such. Two patients experienced labile changes with blood pressure during resection but were resolved with the use of intravenous nicardipine for elevated blood pressure, and crystalloids during bouts of hypotension. All of the patients' blood pressure returned to normal after resection of the mass. Terazosin, a selective alpha 1 antagonist, at a maximum dose of 4 mg per day, may be safely given to Filipino patients diagnosed with pheochromocytoma as first line preoperative blockade.
Pheochromocytoma ; Hypertension

Introduction: COVID-19 emerged as a new disease during the early period of 2020. Given that our institution is a cardiac specialty center and our patients have numerous co-morbidities compared to the general population, we wanted to determine the clinical profiles and in-hospital short-term outcomes of suspect, probable and confirmed adult COVID-19 patients seen at our institution. Methodology: We prospectively enrolled 323 adult (115 health care workers) suspect, probable and confirmed COVID- 19 patients admitted from March to June 2020. We described and analyzed their clinical presentation, and in-hospital outcomes. Results: There were 117 (36.22%) RT-PCR positive patients with 36.53% confirmed, 13.00% probable and 50.46% suspect patients. For probable and confirmed patients, 25%, 21.25%, 23.13% 16.25% had no, mild, moderate, and severe symptoms, respectively with 14.28% critical cases. Over-all mortality rate for probable and confirmed cases was 25.54% with 91.3% mortality rate for critical cases. Co-morbidities with statistically significant association with severity of disease were as follows: hypertension, heart disease, cerebrovascular disease, diabetes mellitus and COPD. Conclusion During the early period of the COVID-19 pandemic, only 36.53% of cases admitted at our institution were COVID-19 confirmed by RT-PCR. One-third of the cases were severe and critical, with more clinical instability, increased inflammatory markers, and higher in-hospital morbidity and mortality.
COVID-19 ; Pandemics ; Philippines