# Malignant Pheochromocytoma Presenting as Acute Coronary Syndrome: A Report of a Rare Case

## TL;DR

A rare case of malignant pheochromocytoma presented as acute coronary syndrome, highlighting its unusual cardiac manifestations.

## Contribution

This case report adds to the literature on the uncommon cardiac presentation of pheochromocytoma.

## Key findings

- Pheochromocytoma presented as acute coronary syndrome across multiple hospital admissions.
- Significant obstructive coronary artery disease was observed in the patient.
- The case emphasizes the need for awareness of this rare condition in cardiac presentations.

## Abstract

Pheochromocytomas are rare tumors of the adrenal medulla. The classic presentation for this condition consists of a triad of symptoms: headache, tachycardia, and sweating in an episodic fashion. Rarely, pheochromocytomas are associated with cardiac pathology specifically acute coronary syndrome (ACS) and cardiomyopathy, which is usually attributed to catecholamine excess. They might also present secondary to elevations in blood pressure or arrhythmias. ECG changes are most often encountered as sinus tachycardia. We present a case of previously undiagnosed pheochromocytoma that showed up as ACS across multiple admissions in the setting of significant obstructive coronary artery disease. We aim to contribute to the growing literature reporting this uncommon presentation in order to showcase these cases to the medical audience.