ST-Segment Elevation Myocardial Infarction Related to Potential Spontaneous Coronary Thrombosis in Pheochromocytoma
Fei Chen1, Mingxia Zheng1, Xi Li1
1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Insights
Pheochromocytoma crisis can cause myocardial infarction. This case reveals spontaneous coronary thrombosis as a cause of ST-elevation myocardial infarction (STEMI) in pheochromocytoma crisis, a previously unreported finding.
Area of Science:
- Cardiology
- Endocrinology
- Pathophysiology
Background:
- Pheochromocytoma crisis is a rare, life-threatening emergency caused by excess catecholamines.
- Catecholamine excess can lead to myocardial injury through direct toxicity or reduced coronary blood flow.
- ST-segment elevation myocardial infarction (STEMI) has been observed in pheochromocytoma crisis, but the underlying mechanism remains unclear, with no prior evidence of occlusive coronary thrombus.
Abstract:
Pheochromocytoma crisis is a rare and possibly fatal emergency. Hypersecreted catecholamines may result in myocardial injury via its direct toxic effect on cardiomyocytes or mediating vasoconstriction which will reduce coronary blood flow in this special setting. Interestingly, several case studies have reported the occurrence of ST-segment elevation myocardial infarction in patients with pheochromocytoma crisis. However, no one found the angiographic evidence of occlusive thrombus in the infarct-related coronary artery. Additionally, pheochromocytoma can induce hypercoagulability and promote thrombosis, but spontaneous coronary thrombosis has never been reported in this condition. Here, we report an unusual case of pheochromocytoma crisis presenting with STEMI due to spontaneous coronary thrombosis.
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