Key result
Pheochromocytoma resection resolves severe heart failure presenting as a STEMI mimic.
Why the study?
Pheochromocytoma presenting as acute STEMI without coronary artery abnormalities is rare and poses diagnostic challenges.
Case Report (n=1)
No
Pheochromocytoma should be considered in the differential diagnosis of young patients presenting with STEMI and heart failure without coronary lesions, particularly when accompanied by blood pressure variability.
Pheochromocytoma evaluation may be considered in young patients with reversible HF and BP lability; single cases leave open the need for systematic screening studies.
Pheochromocytoma can cause various cardiovascular complications, but presenting as acute ST-segment elevation myocardial infarction (STEMI) without coronary artery abnormalities is rare. We report the case of a young patient to highlight the associated diagnostic challenges. A 26-year-old female presented with acute chest pain, ST-segment elevation, and elevated cardiac enzymes. Coronary angiography revealed no stenosis. She developed severe heart failure with blood pressure variability (ranging from 153/120 mmHg to 60/40 mmHg). Laboratory results showed elevated catecholamine levels, and imaging identified a 9.7×7.6 cm adrenal mass. Histopathology confirmed pheochromocytoma. This case suggests that pheochromocytoma should be considered in young patients presenting with STEMI and heart failure without coronary lesions, particularly when accompanied by blood pressure variability. It offers a systematic differential diagnosis framework for distinguishing pheochromocytoma crisis from Takotsubo syndrome and acute myocarditis in emergency settings.
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Yi et al. (2026) conducted a case report in Pheochromocytoma presenting as STEMI (n=1). Adrenal mass resection was evaluated. Surgical resection of a pheochromocytoma successfully resolved severe heart failure and a STEMI-like presentation in a 26-year-old female with normal coronary arteries and marked blood pressure variability.
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