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This case emphasizes the importance of considering or identifying pheochromocytoma as an underlying primary etiology for recurrent episodes of TTS and related concerns such as choice of anti-hypertensive agents. Copyright© South Dakota State Medical Association.IMPORTANCE AND OBJECTIVE Dietary supplements and herbs (called naturoceuticals) are commonly used by Americans, but little is known about their use in cardiovascular disease patient populations. The objective was to evaluate naturoceutical use in a sample population of cardiovas