• Kristin Berona, Rita Joshi, Woo Y Joseph YJ Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California., and Joseph Shrager.
• Department of Emergency Medicine, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California.
• J Emerg Med. 2018 Oct 1; 55 (4): e101-e105.

BackgroundExtra-adrenal pheochromocytomas, or paragangliomas, originate from neural crest chromaffin cells and can be found anywhere along the sympathetic chain from head to toe.Case ReportA 34-year-old female presented 4 days postpartum with episodes of palpitations, hypertension, and shortness of breath. Two episodes in the emergency department confirmed hypertension and supraventricular tachycardia (SVT). A mediastinal mass was noted during workup for pulmonary embolus and was subsequently diagnosed as a cardiac paraganglioma. Our patient underwent surgical resection and was doing well 3 months postoperatively. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case represents a rare presentation of mediastinal paraganglioma with episodic SVT and hypertension postpartum, diagnosed during workup for pulmonary embolus. Although exceedingly rare, emergency physicians should consider paragangliomas in the differential of pregnant or postpartum women who present with episodic hypertension, palpitations, headache, and sweating.Copyright © 2018 Elsevier Inc. All rights reserved.

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