{"title":"模仿急性 ST 段抬高型心肌梗死的辉细胞瘤。","authors":"Theresa Ackfeld, Hadrien Beuret, Francesca Mosar, Stephane Cook","doi":"10.1136/bcr-2024-263311","DOIUrl":null,"url":null,"abstract":"<p><p>Phaeochromocytomas are rare catecholamine-secreting tumours, usually benign, originating from chromaffin cells of the adrenal glands. Their typical presentation includes the triad of headaches, sweating and tachycardia due to excessive catecholamine release. However, many patients do not exhibit all three symptoms, making diagnosis challenging. A significant proportion of cases (around 40%) are linked to genetic disorders. Cardiac complications, including life-threatening events, are common.This report details the case of a 43-year-old woman presenting with chest pain, headaches and diaphoresis. Initial ECG showed an anterolateral ST-elevation myocardial infarction pattern, but coronary angiography revealed no arterial disease. The left ventricular angiogram indicated apical ballooning. Elevated blood pressure prompted suspicion of phaeochromocytoma, which was confirmed through positive metanephrine tests.The tumour, located in the right adrenal gland, was successfully removed laparoscopically, and pathological examination confirmed the diagnosis.Phaeochromocytoma should be suspected in patients with unexplained myocardial infarction, labile hypertension and normal coronary arteries, as beta-blockers can be harmful if used in untreated cases.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6000,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647076/pdf/","citationCount":"0","resultStr":"{\"title\":\"Phaeochromocytoma mimicking acute ST-elevation myocardial infarction.\",\"authors\":\"Theresa Ackfeld, Hadrien Beuret, Francesca Mosar, Stephane Cook\",\"doi\":\"10.1136/bcr-2024-263311\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Phaeochromocytomas are rare catecholamine-secreting tumours, usually benign, originating from chromaffin cells of the adrenal glands. Their typical presentation includes the triad of headaches, sweating and tachycardia due to excessive catecholamine release. However, many patients do not exhibit all three symptoms, making diagnosis challenging. A significant proportion of cases (around 40%) are linked to genetic disorders. Cardiac complications, including life-threatening events, are common.This report details the case of a 43-year-old woman presenting with chest pain, headaches and diaphoresis. Initial ECG showed an anterolateral ST-elevation myocardial infarction pattern, but coronary angiography revealed no arterial disease. The left ventricular angiogram indicated apical ballooning. Elevated blood pressure prompted suspicion of phaeochromocytoma, which was confirmed through positive metanephrine tests.The tumour, located in the right adrenal gland, was successfully removed laparoscopically, and pathological examination confirmed the diagnosis.Phaeochromocytoma should be suspected in patients with unexplained myocardial infarction, labile hypertension and normal coronary arteries, as beta-blockers can be harmful if used in untreated cases.</p>\",\"PeriodicalId\":9080,\"journal\":{\"name\":\"BMJ Case Reports\",\"volume\":\"17 12\",\"pages\":\"\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2024-12-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647076/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1136/bcr-2024-263311\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bcr-2024-263311","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
绒毛膜细胞瘤是一种罕见的儿茶酚胺分泌性肿瘤,通常为良性,起源于肾上腺的绒毛膜细胞。由于儿茶酚胺释放过多,其典型表现包括头痛、出汗和心动过速三联征。然而,许多患者并不表现出所有这三种症状,因此诊断具有挑战性。很大一部分病例(约 40%)与遗传疾病有关。本报告详细描述了一名 43 岁女性的病例,她出现胸痛、头痛和全身乏力。初步心电图显示为前外侧 ST 段抬高型心肌梗死,但冠状动脉造影显示没有动脉疾病。左心室血管造影显示心尖气球扩张。该肿瘤位于右侧肾上腺,已通过腹腔镜成功切除,病理检查证实了诊断结果。不明原因心肌梗死、易患高血压且冠状动脉正常的患者应怀疑患有绒毛膜细胞瘤,因为β-受体阻滞剂如果用于未经治疗的病例可能有害。
Phaeochromocytomas are rare catecholamine-secreting tumours, usually benign, originating from chromaffin cells of the adrenal glands. Their typical presentation includes the triad of headaches, sweating and tachycardia due to excessive catecholamine release. However, many patients do not exhibit all three symptoms, making diagnosis challenging. A significant proportion of cases (around 40%) are linked to genetic disorders. Cardiac complications, including life-threatening events, are common.This report details the case of a 43-year-old woman presenting with chest pain, headaches and diaphoresis. Initial ECG showed an anterolateral ST-elevation myocardial infarction pattern, but coronary angiography revealed no arterial disease. The left ventricular angiogram indicated apical ballooning. Elevated blood pressure prompted suspicion of phaeochromocytoma, which was confirmed through positive metanephrine tests.The tumour, located in the right adrenal gland, was successfully removed laparoscopically, and pathological examination confirmed the diagnosis.Phaeochromocytoma should be suspected in patients with unexplained myocardial infarction, labile hypertension and normal coronary arteries, as beta-blockers can be harmful if used in untreated cases.
期刊介绍:
BMJ Case Reports is an important educational resource offering a high volume of cases in all disciplines so that healthcare professionals, researchers and others can easily find clinically important information on common and rare conditions. All articles are peer reviewed and copy edited before publication. BMJ Case Reports is not an edition or supplement of the BMJ.