Hakim Yasmin, Forbes Anna, Khan Momina, Whitelaw Benjamin C
King's College Hospital, Denmark Hill, London.
Acute Med. 2016;15(3):145-148.
Chest pain with elevated serum troponin is a common clinical presentation and is normally managed as suspected myocardial infarction or acute coronary syndrome (ACS). We report a 49 year old man who presented with central chest pain sweating and breathlessness. He had a significantly elevated serum troponin I level and a subsequent angiogram showed near normal coronary arteries. He was subsequently investigated for fever and found to have a 3cm right sided adrenal mass consistent with a pheochromocytoma. After confirmation and appropriate blockade laparoscopic adrenalectomy was performed. Pheochromocytoma may present as a mimic of acute coronary syndrome but this is often unrecognized and leaves the patient at risk of future pheo crisis events which may be fatal.
血清肌钙蛋白升高伴胸痛是一种常见的临床表现，通常按疑似心肌梗死或急性冠状动脉综合征（ACS）进行处理。我们报告一名49岁男性，他出现中央胸痛、出汗和呼吸急促。他的血清肌钙蛋白I水平显著升高，随后的血管造影显示冠状动脉近乎正常。随后他因发热接受检查，发现右侧肾上腺有一个3cm的肿块，符合嗜铬细胞瘤。确诊并进行适当阻断后，实施了腹腔镜肾上腺切除术。嗜铬细胞瘤可能表现为急性冠状动脉综合征的假象，但这往往未被识别，使患者面临未来可能致命的嗜铬细胞瘤危象事件的风险。
