Pheochromocytoma Mimicking an Acute Coronary Syndrome

A 57-year-old woman presented with intermittent, but intensifying, central chest tightness associated with electrocardiographic changes mimicking acute coronary syndrome. Eventually, a malignant pheochromocytoma was found. Elevated plasma catecholamine levels associated with pheochromocytoma can cause myocardial injury in the absence of clinically significant atherosclerotic coronary artery disease. The cardiovascular manifestations of pheochromocytoma are diverse, making early diagnosis challenging. However, rapid recognition and diagnosis of a pheochromocytoma in this setting is important in order to initiate proper therapy and reduce associated morbidity. In the current report, the pathogenesis of cardiovascular manifestations of pheochromocytoma and management of acute coronary syndrome/myocardial infarction in the presence of pheochromocytoma are discussed.