title: Paraganglioma masquerading as acute myocardial infarction and cardiogenic shock.
abstract: Paragangliomas, extra-adrenal pheochromocytomas, are rare catecholamine-secreting tumor. A 34-year-old lady admitted with diagnosis of ST elevation acute myocardial infarction with cardiogenic shock. Left ventricular function, severely depressed, returned to normal after initial stabilization. Coronary angiogram was normal. A para-aortic paraganglioma was diagnosed during the patient's work-up with biochemical studies, computed tomography of abdomen and functional radioisotopes imaging and was eventually surgically resected. This case shows that acute myocardial infarction may be the initial manifestation of these neuroendocrine tumors. Hypertensive emergency, much less elevated blood pressure may not be present at time of presentation.
authors.affiliation: Department of Cardiothoracic Surgery, Sagar Hospital-DSI, Banshankari, Bangalore 560078, India. Electronic address: drtanveerahmad@gmail.com.
authors.forename: Tanveer
authors.initials: T
authors.lastname: Ahmad
authors.affiliation: Department of Cardiology, Sagar Hospital-DSI, Banshankari, Bangalore 560078, India.
authors.forename: Shankaragouda
authors.initials: S
authors.lastname: Patil
authors.affiliation: Department of Cardiothoracic Surgery, Sagar Hospital-DSI, Banshankari, Bangalore 560078, India.
authors.forename: Ashwini Kumar
authors.initials: AK
authors.lastname: Pasarad
authors.affiliation: Department of Anaesthesia, Sagar Hospital-DSI, Banshankari, Bangalore 560078, India.
authors.forename: Nandakumar Neralakere
authors.initials: NN
authors.lastname: Maheshwarappa
authors.affiliation: Department of Cardiology, Sagar Hospital-DSI, Banshankari, Bangalore 560078, India.
authors.forename: Kolkebaile Sadanand
authors.initials: KS
authors.lastname: Kishore
mesh_terms: D000328:Adult; D001706:Biopsy; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology*; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D010236:Paraganglioma, Extra-Adrenal / Q000150:complications / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D012186:Retroperitoneal Neoplasms / Q000150:complications / Q000175:diagnosis*; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis*; D012770:Shock, Cardiogenic / Q000175:diagnosis*; D018608:Ultrasonography, Doppler
keywords: Acute myocardial infarction; Cardiogenic shock; Paragangliomas; Pulmonary edema