Key result
Laparoscopic adrenalectomy successfully treats a phaeochromocytoma presenting as a STEMI with normal coronary arteries.
Why the study?
Diagnosis of phaeochromocytoma is challenging because many patients lack the classic triad of symptoms, while cardiac complications and presentations mimicking acute myocardial infarction can occur.
Case Report (n=1)
Phaeochromocytoma should be considered in the differential diagnosis for patients presenting with unexplained myocardial infarction, labile hypertension, and normal coronary arteries.
May support considering phaeochromocytoma in unexplained STEMI with normal coronaries; hypothesis-generating case report requiring validation.
Phaeochromocytomas are rare catecholamine-secreting tumours, usually benign, originating from chromaffin cells of the adrenal glands. Their typical presentation includes the triad of headaches, sweating and tachycardia due to excessive catecholamine release. However, many patients do not exhibit all three symptoms, making diagnosis challenging. A significant proportion of cases (around 40%) are linked to genetic disorders. Cardiac complications, including life-threatening events, are common.This report details the case of a 43-year-old woman presenting with chest pain, headaches and diaphoresis. Initial ECG showed an anterolateral ST-elevation myocardial infarction pattern, but coronary angiography revealed no arterial disease. The left ventricular angiogram indicated apical ballooning. Elevated blood pressure prompted suspicion of phaeochromocytoma, which was confirmed through positive metanephrine tests.The tumour, located in the right adrenal gland, was successfully removed laparoscopically, and pathological examination confirmed the diagnosis.Phaeochromocytoma should be suspected in patients with unexplained myocardial infarction, labile hypertension and normal coronary arteries, as beta-blockers can be harmful if used in untreated cases.
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Ackfeld et al. (2024) conducted a case report in Phaeochromocytoma mimicking acute ST-elevation myocardial infarction (n=1). Laparoscopic tumour removal was evaluated. A 43-year-old woman presenting with a STEMI pattern and normal coronary arteries was successfully treated with laparoscopic removal of a right adrenal phaeochromocytoma.