Ruptured pheochromocytoma presents as acute myocardial infarction

Pheochromocytomas are uncommon catecholamine-secreting tumors. The most common symptoms are of paroxysmal or sustained hypertension, or symptoms of paroxysmal adrenergic stimulation as palpitation, headache, and diaphoresis. The diversity of presentation often delays the diagnosis and is sometimes with catastrophic outcome. It had not been reported that acute myocardial infarction is a complication of ruptured pheochromocytoma. We describe a case with emergency department presented as acute myocardial infarction initially. On the following day, sudden drop of blood pressure and syncope attacked him. Coronary angiography revealed noncritical obstruction on proximal left anterior descending artery. After angioplasty, the patient still experienced episodes of hemodynamic collapse, and left flank pain developed. Abdominal computer tomogram demonstrated a large left adrenal tumor with fluid accumulation. Finally, the patient underwent surgical treatment and pathology confirmed the diagnosis.