# A Case Report and Literature Review of Pheochromocytoma Without Tachycardia

## TL;DR

A 47-year-old woman with pheochromocytoma showed no tachycardia despite symptoms, highlighting variability in how the condition presents.

## Contribution

The case reveals that palpitations in pheochromocytoma may not always correlate with tachycardia, suggesting individual differences in cardiovascular responses.

## Key findings

- The patient experienced palpitations but no tachycardia during 28 days of continuous monitoring.
- Only 20% of pheochromocytoma patients with palpitations show detectable tachycardia or arrhythmias.
- The case highlights the need for personalized diagnostic and management strategies for pheochromocytoma.

## Abstract

This case report highlights a 47-year-old woman with an adrenal incidentaloma and a history of polysubstance abuse, finally diagnosed with pheochromocytoma. Characterized by episodic hypertension, headaches, and palpitations, pheochromocytoma is a rare condition with potential complications like uncontrolled hypertension and heart failure. Remarkably, during her 28-day hospitalization, continuous monitoring revealed no instances of tachycardia or arrhythmias despite multiple symptomatic episodes. This finding aligns with reports that while 50-70% of symptomatic pheochromocytoma patients experience palpitations, only about 20% exhibit detectable tachycardia or arrhythmias. This discrepancy suggests varied individual cardiovascular responses to catecholamine surges, possibly due to differences in catecholamine inactivation rates and receptor sensitivity. This case underscores the complexity of pheochromocytoma symptoms and highlights the need for personalized diagnostic and management strategies. Furthermore, it points to a significant gap in understanding the correlation between palpitations and arrhythmia in pheochromocytoma, indicating a critical area for future research.