Phaeochromocytoma found on cardiovascular magnetic resonance in a patient presenting with acute myocarditis: an unusual association

BMJ Case Rep. 2018 Jun 8:2018:bcr2017222621. doi: 10.1136/bcr-2017-222621.

Abstract

Myocarditis is inflammation of the cardiac muscle. The symptoms, signs and basic investigation findings can mimic that of myocardial infarction. The most common cause is infection (most commonly viral). Cardiovascular magnetic resonance (CMR) is the gold standard non-invasive diagnostic test for potential acute myocarditis as it allows assessment of myocardial oedema and scar. A man aged 25 years was admitted with chest pain, dizziness, headache, palpitations and sweating. His troponin was mildly positive. A CMR was performed which showed mild myocarditis and a right suprarenal mass which was confirmed to be a phaeochromocytoma based on biochemistry and a dedicated imaging workup. Phaeochromocytoma can lead to cardiac involvement in the form of left ventricular dysfunction, or catecholamine-induced myocarditis.

Keywords: adrenal disorders; cardiovascular system; endocrine system; heart failure; hypertension.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adrenalectomy / methods
  • Adult
  • Chest Pain / diagnosis
  • Chest Pain / etiology
  • Echocardiography / methods
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Magnetic Resonance Imaging, Cine / methods*
  • Male
  • Myocarditis / complications
  • Myocarditis / diagnostic imaging*
  • Myocarditis / drug therapy
  • Pheochromocytoma / complications
  • Pheochromocytoma / diagnostic imaging*
  • Pheochromocytoma / surgery
  • Treatment Outcome
  • Ventricular Dysfunction, Left / complications
  • Ventricular Dysfunction, Left / diagnostic imaging