Pheochromocytoma-related cardiomyopathy presenting as acute myocardial infarction

Abstract

Abstract Introduction: Pheochromocytoma (PHEO)-related cardiomyopathy is a rare condition in which release of a large amount of catecholamines leads to severe vasoconstriction, coronary vasospasm, myocardial ischemia, injury, and necrosis. Its clinical manifestations can be similar to those of acute coronary syndrome. Patient concerns: A 63-year-old woman was diagnosed with acute non-ST segment elevation myocardial infarction following chest pain for 8\u200ahours. The results of coronary angiography were normal. The patient developed dyspnea, cough with frothy pink sputum, paroxysmal sweating, arrhythmia, and blood pressure fluctuation, and was transferred to the intensive care unit for monitoring and treatment. Diagnosis: PHEO, catecholamine cardiomyopathy (CICMP) Intervention: After monitoring the pulse index continuous cardiac output and treatment with α and β adrenergic receptor blockers for 18\u200adays, laparoscopic resection of the left adrenal mass was performed. Outcomes: The patient s condition improved and she was discharged 31\u200adays after admission. Outpatient follow-up examinations 1\u200amonth and 1\u200ayear later did not show recurrence. Lessons: PHEO can cause CICMP, the manifestations of which are partly similar to those of takotsubo cardiomyopathy (TTC). Once the patient s condition stabilizes, surgery should be considered. Fluid management is necessary, and agents such as α and β adrenergic receptor blockers should be administered.