title: Pheochromocytoma presenting as acute non-ST elevation myocardial infarction following elective hysterectomy.
abstract: BACKGROUND
  Studies have shown patients with pheochromocytoma have a 14-fold higher rate of cardiovascular events than patients with essential hypertension.
  
  
  METHODS
  A 47-year-old female was found to have elevated troponins and marked ST depression following elective hysterectomy. The patient underwent cardiac catheterization, and labile blood pressures with a narrow-complex tachycardia were noted during the procedure. No evidence of coronary artery disease or wall motion abnormality was found. After catheterization, the patient complained of abdominal pain with difficulty passing gas. CT abdomen/pelvis revealed a 4.3 x 5 cm left adrenal mass. Plasma metanephrines and 24-hour urine catecholamines suggested pheochromocytoma. She underwent left total adrenalectomy, and pathology confirmed pheochromocytoma. At 3-month follow-up, she was asymptomatic and required only one agent for blood pressure control.
  
  
  CONCLUSIONS
  Suspecting pheochromocytoma in patients with an unexpected myocardialevent and labile hypertension can lead to prompt diagnosis and appropriate preoperative management as well as avoidance of unnecessary procedures.
authors.forename: William B
authors.initials: WB
authors.lastname: Horton
authors.forename: Lane M
authors.initials: LM
authors.lastname: Frey
authors.forename: Urseline A
authors.initials: UA
authors.lastname: Hawkins
authors.forename: Shema R
authors.initials: SR
authors.lastname: Ahmad
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D010673:Pheochromocytoma / Q000150:complications*; D011183:Postoperative Complications