Pheochromocytoma presenting as an acute coronary syndrome complicated by acute heart failure: The challenge of a great mimic.
Pheochromocytoma is a rare neuroendocrine tumor with a highly variable clinical presentation. The serious and potentially lethal cardiovascular complications of these tumors are related to the effects of secreted catecholamines. We describe a case of a 50-year-old woman urgently admitted to our hospital because of symptoms and clinical and instrumental findings consistent with an acute coronary syndrome complicated by acute heart failure. Urgent coronary angiography showed normal coronary arteries. During her hospital stay, the recurrence of episodes characterized by a sudden increase in blood pressure, cold sweating, and nausea allowed us to hypothesize a pheochromocytoma. The diagnosis was confirmed by elevated levels of urinary catecholamines and by the finding of a left adrenal mass on magnetic resonance imaging. The patient underwent left adrenalectomy. Therefore, the initial diagnosis was critically reappraised and reviewed as a cardiac manifestation of a pheochromocytoma during catecholaminergic crisis.
Unità Operativa di Cardiologia, Ospedale SS Annunzia, Sassari, aItaly.
Giuseppe Damiano
GD
Sanna
Unità Operativa di Cardiologia, Ospedale SS Annunzia, Sassari, aItaly.
Giuseppe
G
Talanas
Unità Operativa di Cardiologia, Ospedale SS Annunzia, Sassari, aItaly.
Giuseppina
G
Fiore
Unità Operativa di Cardiologia, Ospedale SS Annunzia, Sassari, aItaly.
Antonella
A
Canu
Unità Operativa di Cardiologia, Ospedale SS Annunzia, Sassari, aItaly.
Pierfranco
P
Terrosu
Acute coronary syndrome; Arterial hypertension; Heart failure; Pheochromocytoma
Heart Vessels. 2003 Mar;18(1):32-9
12644879
Arch Intern Med. 1987 Jul;147(7):1289-93
3606286
Br J Anaesth. 2000 Jul;85(1):44-57
10927994
Arq Bras Cardiol. 2004 Feb;82(2):178-80, 175-7
15042254
BMJ Case Rep. 2015 Aug 30;2015:
26323979
Lancet. 2005 Aug 20-26;366(9486):665-75
16112304
Am J Emerg Med. 2003 Nov;21(7):578-84
14655241
Am J Emerg Med. 2000 Sep;18(5):622-5
10999582
Am J Cardiol. 2015 Jun 1;115(11):1615-8
25851794
J Cardiovasc Ultrasound. 2011 Jun;19(2):76-82
21860721