Multivessel coronary artery ectasia and severe calcification in a patient with pheochromocytoma: a case report

Area of Science:

• Cardiology
• Endocrinology
• Vascular Medicine

Background:

• Multivessel coronary artery ectasia (MACE) with severe calcification is uncommon in coronary artery disease (CAD).
• Long-standing, poorly controlled hypertension is a known risk factor for CAD.
• Pheochromocytoma, a rare tumor causing hypertension, can have long-term cardiovascular effects.

Purpose of the Study:

• To report a rare case of MACE with severe calcification.
• To explore the potential association between MACE and hypertension secondary to pheochromocytoma.
• To describe the management and outcome of such a complex case.

Main Methods:

• Case report of a 74-year-old woman presenting with acute myocardial infarction.
• Coronary angiography to diagnose multivessel coronary artery ectasia and occlusion.
• Percutaneous coronary intervention including aspiration thrombectomy and balloon angioplasty.

Main Results:

• The patient presented with acute myocardial infarction and total occlusion of the left anterior descending artery.
• Coronary angiography revealed multivessel ectasias with severe calcification in the left main, circumflex, and right coronary arteries.
• Successful revascularization achieved grade 3 coronary flow, with no cardiac events at 12-month follow-up.

Conclusions:

• Multivessel coronary artery ectasia and severe calcification can occur in patients with a history of hypertension secondary to pheochromocytoma.
• This case underscores the importance of considering rare underlying conditions in complex cardiovascular presentations.
• Effective management of acute coronary syndromes in patients with MACE is achievable.