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A 43-year-old woman with a 2-year history of labile ...

Unopposed α-adrenergic tone

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submitted by xxabi(96),

Starting beta blockers before alpha blockade in pheochromocytoma is contraindicated. Beta blockers cancel out the vasodilatory effect of peripheral beta-2 adrenoceptors, potentially leading to unopposed alpha-adrenoceptor stimulation → vasoconstriction → hypertensive crisis.