Myocardial infarction as a mask for catecholamine-induced cardiomyopathy against the background of pheochromocytoma

Abstract

Pheochromocytoma (PC) is a tumor of chromaffin cells of the sympathetic-adrenal system that produces a large amount of catecholamines (adrenaline, norepinephrine, dopamine). There are no reliable data in the literature on the frequency of cardiac manifestations of pheochromocytoma, which is associated with the rarity of this pathology. This case demonstrates the development of catecholamine-induced cardiomyopathy, proceeding under the guise of a heart attack, as the primary manifestation of pheochromocytoma. The patient was referred with a diagnosis of «Ischemic heart disease, myocardial infarction» to perform coronary angiography, according to the result of the study, no pathology of the coronary arteries was detected. In the process of additional examination, a pheochromocytoma of the left adrenal gland was revealed. The initial changes in the electrocardiogram, echocardiographic examination, and laboratory parameters regressed, which confirmed the development of cardiomyopathy that developed against the background of pheochromocytoma. Currently, there is an increasing amount of information about non-ischemic myocardial damage in patients with pheochromocytoma. These changes in the form of clinical manifestations (pain behind the sternum, shortness of breath, various types of arrhythmias) as well as non-specific changes according to ECG data, disturbances of local kinetics with a decrease in global myocardial contractility without stenotic damage to the coronary artery were called catecholamine-induced cardiomyopathy.