Adrenaline rush: an unusual presentation of phaeochromocytoma.
A 44-year-old man presented to the accident and emergency department with chest pain and shortness of breath. Admission ECG revealed ischaemic changes. He had markedly elevated troponin T and a severely impaired left ventricular ejection fraction with regional motion wall abnormalities. He was initially treated in intensive care for acute myocardial infarction. When his renal function improved, an angiogram was performed, which showed unobstructed coronary arteries. He was later found to have a phaeochromocytoma. This case illustrates a rare diagnosis presenting with common symptoms that could easily have been missed. On admission to hospital, patients can easily be labelled with a diagnosis and put on a treatment pathway, such as acute coronary syndrome. It is important for clinicians to keep an open mind and be prepared to review the diagnosis if the history does not fit.
Department of Cardiology, The Essex Cardiothoracic Centre (CTC), Essex, UK.
Benjamin
B
Lindsey
Department of General Medicine, Basildon and Thurrock University Hospital, Essex, UK.
Mark David
MD
Eisner
Department of Cardiology, The Essex Cardiothoracic Centre (CTC), Essex, UK.
Hannah Katherine
http://orcid.org/0000-0003-4242-6539
HK
Mitchell
Department of Cardiology, The Essex Cardiothoracic Centre (CTC), Essex, UK.
Gerald
G
Clesham
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000787:Angina Pectoris / Q000175:diagnosis; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology; D004562:Electrocardiography; D004837:Epinephrine / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis; D010673:Pheochromocytoma / Q000175:diagnosis*; D016896:Treatment Outcome; D020107:Troponin T / Q000378:metabolism
D000319:Adrenergic beta-Antagonists; D020107:Troponin T; D004837:Epinephrine