Vilcant Viliane
J Am Osteopath Assoc. 2017 Aug 1;117(8):537-540. doi: 10.7556/jaoa.2017.104.
Pheochromocytoma is a rare catecholamine-secreting tumor with a prevalence of 0.1% to 0.6% in hypertensive patients. The classic triad of symptoms is headache, palpitations, and diaphoresis, but clinical presentation varies greatly. Pheochromocytoma can also mimic acute coronary syndrome and heart failure. With surgical resection, appropriate preoperative medical therapy, and 10% malignancy rate, prognosis is usually good. In the present case, a patient presented to the emergency department with symptoms suggesting a non-ST-segment elevation myocardial infarction and was transferred to a tertiary medical center for a cardiac catheterization. No coronary artery disease was found. However, cardiomyopathy developed, which made pheochromocytoma difficult to diagnose at first glance.
嗜铬细胞瘤是一种罕见的分泌儿茶酚胺的肿瘤，在高血压患者中的患病率为0.1%至0.6%。经典的三联征症状是头痛、心悸和多汗，但临床表现差异很大。嗜铬细胞瘤也可类似急性冠状动脉综合征和心力衰竭。通过手术切除、适当的术前药物治疗以及10%的恶性率，预后通常良好。在本病例中，一名患者因提示非ST段抬高型心肌梗死的症状就诊于急诊科，并被转至三级医疗中心进行心脏导管插入术。未发现冠状动脉疾病。然而，出现了心肌病，这使得嗜铬细胞瘤乍一看难以诊断。
