One case of acute myocardial injury induced pheochromocytoma and paraganglioma

Abstract

Abstract Background Pheochromocytoma and paraganglioma (PPGL) are neuroendocrine tumors respectively originating from the adrenal medulla and extra-adrenal sympathetic ganglia. The coexistence of pheochromocytoma and paraganglioma is known as composite pheochromocytoma. High levels of catecholamines secreted by PPGL can cause acute myocardial injuries and cardiac dysfunction, such as acute heart failure, pulmonary embolism, cardiogenic shock, and tachyarrhythmia. PPGL is a rare disease. In the clinic, it is easy to ignore or delay diagnosis, resulting in misdiagnosis of patients or untimely treatment. Case presentation A 37-year-old woman presented with headache, chest discomfort, and abdominal pain. At the time of the attack, the patient had a maximum blood pressure of 167/90mmHg and a heart rate of 100 beats per minute. Chest computed tomography revealed a mass inside the left adrenal limb. The level of methoxy-catecholamines in the urine sample exceeded the reference values, confirming the diagnosis of adrenal pheochromocytoma. The patient was orally administered adrenergic blockers to relieve symptoms. After a left adrenal mass resection, the plasma catecholamine level was normal, and postoperative medication was discontinued. At the telephone follow-up, the patient complained of occasional episodes of palpitation, but no pain or other discomfort. Conclusions We present a case of acute myocardial injury caused by PPGL and conduct a relevant literature review to provide experience for the clinic. In young female patients lacking cardiovascular risk factors presenting with episodes of hypertension and chest tightness, it is recommended to refine CT for the presence of adrenal masses and to rule out circulatory complications promptly. All patients with PPGL are advised to refine genetic testing.