BACKGROUND: pheochromocytoma is a neuroendocrine tumor that secretes high levels of catecholamines and it is able to exert serious cardiovascular effects. The cardiac involvement is the most frequent, with reported conditions such as transient myocardial dysfunction, acute coronary syndrome and ventricular arrhythmias. CLINICAL CASE: we reported a 36 year-old woman without cardiovascular history. She presented with an adrenergic crisis after surgery leading to acute heart failure and acute myocardial infarction. The electrocardiogram showed an ST-segment elevation and positive enzymatic curve, motion alterations in echocardiography and ventriculography without coronary arteries lesions. She was screened for secondary hypertension protocol with a 24 hour urine free catecholamine sample that was clearly elevated. Abdomen computed tomography and magnetic resonance imaging showed a tumor located in the right adrenal gland and she underwent surgical resection. CONCLUSIONS: pheochromocytoma has different clinical presentations that may delay the diagnosis. Early recognition of catecholamine-induced cardiomyopathy and adequate management reduces morbidity and mortality.
BACKGROUND:pheochromocytoma is a neuroendocrine tumor that secretes high levels of catecholamines and it is able to exert serious cardiovascular effects. The cardiac involvement is the most frequent, with reported conditions such as transient myocardial dysfunction, acute coronary syndrome and ventricular arrhythmias. CLINICAL CASE: we reported a 36 year-old woman without cardiovascular history. She presented with an adrenergic crisis after surgery leading to acute heart failure and acute myocardial infarction. The electrocardiogram showed an ST-segment elevation and positive enzymatic curve, motion alterations in echocardiography and ventriculography without coronary arteries lesions. She was screened for secondary hypertension protocol with a 24 hour urine free catecholamine sample that was clearly elevated. Abdomen computed tomography and magnetic resonance imaging showed a tumor located in the right adrenal gland and she underwent surgical resection. CONCLUSIONS:pheochromocytoma has different clinical presentations that may delay the diagnosis. Early recognition of catecholamine-induced cardiomyopathy and adequate management reduces morbidity and mortality.