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.
Department of Cardiology and Angiology, University Hospital Gent, Gent, Belgium.
T L
TL
De Backer
M L
ML
De Buyzere
Y
Y
Taeymans
P
P
Kunnen
R
R
Rubens
D L
DL
Clement
D000310:Adrenal Gland Neoplasms / Q000150:complications*; D000328:Adult; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology*; D010673:Pheochromocytoma / Q000150:complications*