Pheochromocytoma: Cath lab opening up the pandora's box

Pheochromocytoma is a catecholamine secreting neuroendocrine tumor arising from chromaffin cells in the adrenal medulla or extraadrenal paraganglia. The classic triad of symptoms consists of episodic headache, palpitations and diaphoresis. Pheochromocytomas can result in various cardiac manifestations including systemic hypertension, ventricular hypertrophy and congestive heart failure due to prolonged hypertension. They can also manifest with arrhythmias, myocarditis and dilated cardiomyopathy due to toxic exposure to catecholamines, or occasionally as acute coronary syndrome. Here, we describe a case who presented very similar to acute coronary syndrome with elevated cardiac biomarkers and was taken into catheterization lab. His coronaries were normal but he was incidentally detected to have suprarenal mass during angiography. He was finally diagnosed as having pheochromocytoma. Subsequently he was surgically treated and cured.