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嗜铬细胞瘤诱发的心肌梗死:一例报告。

Pheochromocytoma-induced myocardial infarction: A case report.

作者信息

Tang Haixia, Liu Jichun, Hu Bangsheng, Yang Yuwen, Xie Xiangrong, Wei Youquan

机构信息

Department of Cardiology, The First Affiliated Hospital of Wannan Medical College, Wuhu 241000, Anhui, China.

出版信息

Open Life Sci. 2024 Feb 24;19(1):20220830. doi: 10.1515/biol-2022-0830. eCollection 2024.

Abstract

The pheochromocytoma is an uncommon endocrine neoplasm that originates from chromaffin cells and causes significant cardiovascular effects through the intermittent or sustained release of catecholamines. In this report, we present a rare case of myocardial infarction (MI) induced by pheochromocytoma. A 53-year-old female presented to the emergency department with a history of intermittent palpitations, back pain, and sweating for over 10 years, which had worsened over the past 2 days. The patient's cardiac enzymes and troponin levels were significantly elevated, and the electrocardiogram (ECG) showed ST-segment elevation, leading to an initial diagnosis of acute myocardial infarction. Echocardiography revealed apical ballooning, indicative of stress cardiomyopathy. Emergency coronary angiography revealed no significant stenosis, and the patient's blood pressure was fluctuating. Computerized tomography (CT) scan of the adrenal gland revealed a bilateral adrenal mass, with the left adrenal mass being larger in size after contrast-enhanced CT scan. The patient's left adrenal gland was successfully removed through laparoscopic adrenalectomy, and histopathology results confirmed the presence of adrenal pheochromocytoma. Follow-up for 3 months after discharge showed the patient had no symptoms and good prognosis. The abnormal findings on echocardiography and ECG resolved. Prompt diagnosis and management of pheochromocytoma are crucial for a favorable prognosis.

摘要

嗜铬细胞瘤是一种罕见的内分泌肿瘤,起源于嗜铬细胞,通过儿茶酚胺的间歇性或持续性释放引起显著的心血管效应。在本报告中,我们呈现了一例由嗜铬细胞瘤诱发心肌梗死(MI)的罕见病例。一名53岁女性因间歇性心悸、背痛和出汗超过10年的病史就诊于急诊科,在过去2天病情加重。患者的心肌酶和肌钙蛋白水平显著升高,心电图(ECG)显示ST段抬高,初步诊断为急性心肌梗死。超声心动图显示心尖部气球样改变,提示应激性心肌病。急诊冠状动脉造影显示无明显狭窄,且患者血压波动。肾上腺计算机断层扫描(CT)显示双侧肾上腺肿块,增强CT扫描后左肾上腺肿块更大。通过腹腔镜肾上腺切除术成功切除患者的左肾上腺,组织病理学结果证实存在肾上腺嗜铬细胞瘤。出院后3个月的随访显示患者无症状且预后良好。超声心动图和心电图上的异常表现消失。对嗜铬细胞瘤的及时诊断和处理对于良好的预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0482/10921470/112aa695f77e/j_biol-2022-0830-fig001.jpg

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