Cardiac involvement in pheochromocytoma.
We report the details of a 40-year-old farmer, a cigarette smoker, who was admitted with general malaise, nausea, vomiting, upper abdominal pain, with ST-elevation on ECG suggestive of an acute anterolateral myocardial infarction. He was treated with nitrates, heparin, beta-blockade and angiotensin-converting enzyme (ACE) inhibitors. Because of the presence of some blood while vomiting no thrombolysis was given and abdominal echography was performed. This revealed a nodular mass at the right adrenal gland. Urinary catecholamines and abdominal magnetic resonance imaging confirmed the suspected diagnosis of pheochromocytoma. Before adrenectomy, a coronary angiography under alpha blocker therapy was performed, which demonstrated no significant coronary artery disease, although the patient showed ST-elevations on ECG. Pathological examination of the adrenal tumor was compatible with a diagnosis of pheochromocytoma. Postoperatively urinary catecholamines dropped dramatically, and the ECG normalised slowly over time. After 8 months the patient is still well. Blood pressure is well controlled with no antihypertensive drugs and exercise testing shows no evidence of myocardial ischaemia.
De Backer
T L
TL
Department of Cardiology and Angiology, University Hospital Gent, Gent, Belgium.
De Buyzere
M L
ML
Taeymans
Y
Y
Kunnen
P
P
Rubens
R
R
Clement
D L
DL
D000310:Adrenal Gland Neoplasms / Q000150:complications*; D000328:Adult; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology*; D010673:Pheochromocytoma / Q000150:complications*