We report the case of a 44-year-old patient who came to the emergency department with chest pain of oppressive character, non-irradiated, not lisp with rest and accompanied by vegetative symptoms.
An ECG showed ST-segment depression in the inferior, lateral and anteroseptal faces.
With the diagnosis of acute coronary syndrome is admitted to the Department of Cardiology.
Coronary angiography was performed, which showed no evidence of coronary artery lesions.
Echocardiography showed left ventricular hypertrophy and severe systolic dysfunction and circumferential segmental alterations at the base and middle segments.
During his stay in the Coronary Care Unit, he presented episodes of self-limiting ventricular tachycardia without hemodynamic repercussions.
Because this is a young male, with no previous medical or surgical history, who has acute coronary syndrome with normal coronary arteries, the diagnostic possibility of pheochromocytoma is raised.
Catechols and derivatives were requested and homovalinic acid and vanimandelic acid values increased.
Thyroid tests and baseline cortisol were normal.
A CT scan showed a heterogeneous right adrenal mass of 4.5x3.5 cm in anteroposterior and transverse diameter, rounded with defined borders.
Given the finding of adrenal abdominal mass, it was decided to perform a laparoscopic transperitoneal supraadrenalectomy, after the establishment of double adrenergic block.
