# Catecholamine-Induced Myocarditis in Undetected Pheochromocytoma

## TL;DR

A young woman with undiagnosed pheochromocytoma was initially misdiagnosed with heart conditions, but recovered after surgery.

## Contribution

Highlights the importance of considering pheochromocytoma in cases of unexplained cardiac dysfunction.

## Key findings

- The patient was misdiagnosed with Takotsubo cardiomyopathy and myocarditis before pheochromocytoma was identified.
- Periodic hypertension episodes led to pheochromocytoma screening and successful treatment via adrenalectomy.
- The case underscores the need for high clinical suspicion to avoid misdiagnosis.

## Abstract

Pheochromocytoma is a neuroendocrine tumor of the adrenal gland. It can cause a range of symptoms, but the main ones are palpitations, pallor, headaches, and sweating. Due to its rarity and episodic character, it is frequently misdiagnosed in the initial instance.

We report the case of a young woman in her twenties who was misdiagnosed with hypotension, headache, cough, and palpitations, and an echocardiography revealed reduced cardiac function. She was initially diagnosed with Takotsubo cardiomyopathy and then with myocarditis based on clinical and radiological findings, and she was treated for cardiogenic shock. She continued to have a headache, which was diagnosed as a cardiac cephalalgia. Despite receiving topiramate and analgesia, she continued to have headaches and hypotension. She was found to have periodic episodes of hypertension, prompting a pheochromocytoma screening. She had a successful adrenalectomy and recovered well. This case report emphasizes the significance of having a high degree of suspicion for pheochromocytoma in individuals presenting with unexplained cardiac dysfunction.