Acute coronary syndrome leading to a new diagnosis of phaeochromocytoma following a profound intraprocedural hypertensive surge

John Graby, Zi Wei Goh, Naik Haya, Kevin Carson

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Phaeochromocytomas are rare neuroendocrine tumours, which can significantly increase the risk of cardiovascular morbidity and mortality. They are also recognised as 'the great mimic' and can present in many ways. A 42-year-old male patient presented with a non-ST elevation acute coronary syndrome and was medically treated pending an invasive coronary angiogram. During this procedure, he suffered a profound, symptomatic hypertensive surge documented with invasive pressure monitoring. This raised concern for potential secondary causes of hypertension, particularly given his age. He was subsequently diagnosed with a phaeochromocytoma, and after surgical resection of the tumour, his blood pressure control improved and he remains on single therapy only. As clinicians, it is important to remain alert for previously undiagnosed comorbidities contributing to common pathology, including rare, but life-threatening conditions as we present in this case.

Original languageEnglish
Article numbere240933
JournalBMJ Case Reports
Issue number3
Early online date22 Mar 2021
Publication statusPublished - 22 Mar 2021


  • Acute Coronary Syndrome/diagnostic imaging
  • Adrenal Gland Neoplasms/diagnosis
  • Adult
  • Coronary Angiography
  • Humans
  • Hypertension/etiology
  • Male
  • Pheochromocytoma/diagnosis

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