title: Phaeochromocytoma presenting as an acute coronary syndrome.
abstract: A 44-year-old Caucasian man presented to the emergency department in acute cardiogenic shock, with pulmonary oedema, secondary to an acute myocardial infarction and in a hyperosmolar hyperglycaemic state. The previous day he had undergone a colonoscopy, which revealed features of colitis, and was started on prednisolone. He had been previously diagnosed with type 2 diabetes, migraine and anxiety attacks. While awaiting a coronary angiogram he developed abdominal pain and a CT scan was performed and found a large right adrenal mass. Plasma-free metadrenaline levels were elevated. After 4 months, a right adrenalectomy was performed successfully. He made a good recovery with normalisation of his heart function and resolution of his diabetes. The diagnosis was delayed for years due to his episodic symptoms being attributed to other more common diagnoses. Although a rare diagnosis in itself, there are case reports of phaeochromocytoma initially presenting with an acute coronary syndrome.
authors: Basildon University Hospital, Basildon, UK.
authors: Towhid
authors: T
authors: Imam
authors: Basildon University Hospital, Basildon, UK.|Department of Internal Medicine and Endocrinology, Duncan Hospital Raxaul, Raxaul, Bihar, India.
authors: Philip
authors: P
authors: Finny
authors: Department of Endocrinology, Basildon University Hospital, Basildon, UK.
authors: Alan
authors: A
authors: Choo-Kang
authors: Department of Endocrinology, Basildon University Hospital, Basildon, UK.
authors: Rehman
authors: http://orcid.org/0000-0003-1628-9657
authors: R
authors: Khan
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis*; D000315:Adrenalectomy; D000328:Adult; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D010673:Pheochromocytoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed