Pheochromocytoma Masquerading as Acute Coronary Syndrome Complicated by Cardiogenic Shock: A CARE-Compliant Case Report.
Songyan Zhang, Ying Cui, Shucheng Li
✦ AI-curated · Sources linked
Case in brief
A 59-year-old man with a history of intermittent chest tightness presented with acute cardiogenic shock, elevated troponin levels, and reduced left ventricular ejection fraction. Initial coronary angiography showed no significant stenosis, indicating myocardial infarction with non-obstructive coronary arteries. Elevated plasma metanephrine levels and an adrenal mass on imaging led to a diagnosis of pheochromocytoma. Following preoperative management and laparoscopic adrenalectomy, the patient's cardiac function normalized and symptoms resolved.
Diagnostic / clinical pearl
Clinicians should consider pheochromocytoma in patients with MINOCA and unexplained cardiogenic shock, especially when accompanied by labile blood pressure and significantly elevated plasma metanephrines.
Why it matters
This case underscores the importance of recognizing catecholamine-induced cardiomyopathy, which can mimic acute coronary syndrome, and highlights the need for multidisciplinary management in such scenarios.