Article Text
Summary
A 44-year-old Caucasian man presented to the emergency department in acute cardiogenic shock, with pulmonary oedema, secondary to an acute myocardial infarction and in a hyperosmolar hyperglycaemic state. The previous day he had undergone a colonoscopy, which revealed features of colitis, and was started on prednisolone. He had been previously diagnosed with type 2 diabetes, migraine and anxiety attacks. While awaiting a coronary angiogram he developed abdominal pain and a CT scan was performed and found a large right adrenal mass. Plasma-free metadrenaline levels were elevated. After 4 months, a right adrenalectomy was performed successfully. He made a good recovery with normalisation of his heart function and resolution of his diabetes. The diagnosis was delayed for years due to his episodic symptoms being attributed to other more common diagnoses. Although a rare diagnosis in itself, there are case reports of phaeochromocytoma initially presenting with an acute coronary syndrome.
Statistics from Altmetric.com
Footnotes
Contributors TI was involved in working up this patient in detail, presenting this case in their team meeting and writing up the manuscript. PF, managed this patient in the ward, presented him in the medical grand rounds and was involved in his follow-up care. He provided the idea to write up this case and collected all the necessary details towards publication. He edited the final manuscript. AC-K managed this patient and was involved in the clinical management and in the discussion of the clinical management. RK was the endocrine consultant fully involved in the clinical management of this patient and in the follow-up care. He supervised the case presentation and the write-up of this case report.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.