What is the clinical evidence from this study?

Study design: Case Report. Population: Phaeochromocytoma (n=1). Intervention: Phenoxybenzamine and laparoscopic adrenalectomy. Primary outcome: Symptom resolution and blood pressure normalization.

What question did this study set out to answer?

To present a rare case of phaeochromocytoma with challenging cardiac symptoms and emphasize diagnostic considerations.

June 1, 2026Open Access

More Than Myocarditis? Cardiac Involvement in Phaeochromocytoma—A Case Report

Q: What does this research mean for the field?

Phaeochromocytoma can mimic acute coronary syndrome and myocarditis through catecholamine-induced cardiac effects, requiring a high index of suspicion in patients with unexplained cardiovascular symptoms and refractory hypertension. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Treatment with phenoxybenzamine and subsequent laparoscopic adrenalectomy resulted in complete resolution of cardiovascular symptoms and normalization of blood pressure in a patient with phaeochromocytoma mimicking myocarditis.

Key Points

To present a rare case of phaeochromocytoma with challenging cardiac symptoms and emphasize diagnostic considerations.
Presented a case of a 54-year-old female with acute chest pain and atrial fibrillation.
Investigated with coronary angiography, ECG, and urinary metanephrines to confirm phaeochromocytoma.
Treated with phenoxybenzamine and bisoprolol, followed by laparoscopic adrenalectomy.
Diagnosis confirmed with significantly elevated urinary metanephrines.
Blood pressure stabilised after treatment and symptoms resolved by follow-up.
Patient remained in sinus rhythm with normalised blood pressure post-surgery.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 54-year-old female presenting with acute chest pain and atrial fibrillation initially suggestive of acute coronary syndrome, subsequently diagnosed with phaeochromocytoma and followed for 6 months postoperatively.

Intervention

Phenoxybenzamine titrated to 10 mg twice daily, bisoprolol, and laparoscopic adrenalectomy.

Outcome

Stabilisation of blood pressure and heart rate, maintenance of sinus rhythm, and resolution of symptoms.

Phaeochromocytoma can present with acute chest pain and atrial fibrillation mimicking acute coronary syndrome or myocarditis, highlighting the need for a high index of suspicion in patients with unexplained cardiovascular symptoms.

Limitations

This report describes a single-patient experience, and therefore its findings may not be generalisable to all cases of phaeochromocytoma.
Biochemical and imaging data were limited to what was clinically available at the time.
Follow-up was limited to 6 months postoperatively, so longer-term outcomes and potential late complications could not be assessed.

Abstract

AIMS/BACKGROUND: Phaeochromocytoma is a rare catecholamine-secreting neuroendocrine tumour arising from chromaffin cells of the adrenal medulla or from extra-adrenal paraganglionic tissue, in which case it is termed paraganglioma. Its clinical presentations are highly variable with up to 10-20% of patients being asymptomatic or having non-specific symptoms, therefore leading to frequent misdiagnosis. The aim of this case report is to present a rare and diagnostically challenging presentation as well as highlight the need to maintain a high index of suspicion in patients with unexplained cardiovascular symptoms. CASE PRESENTATION: A 54-year-old female presented with acute chest pain and atrial fibrillation, initially suggestive of acute coronary syndrome. However, coronary angiography demonstrated unobstructed coronary arteries, and electrocardiogram (ECG) changes resolved. Persistent symptoms and refractory hypertension prompted further investigation, which revealed a left adrenal mass and significantly elevated urinary metanephrines, consistent with a diagnosis of phaeochromocytoma. RESULTS: After the diagnosis was confirmed by Endocrinology, treatment with phenoxybenzamine was initiated and titrated to 10 mg twice daily, resulting in stabilisation of her blood pressure and heart rate. Bisoprolol was added for further rate control. Following preoperative optimisation, the patient later underwent an uncomplicated laparoscopic adrenalectomy. At follow-up, she remained in sinus rhythm with a normalised blood pressure and resolution of symptoms. CONCLUSION: This case highlights the diagnostic challenge posed by phaeochromocytoma, which can mimic myocardial infarction and myocarditis due to catecholamine-induced cardiac effects.

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