DILATED CARDIOMYOPATHY WITH HIDDEN PHEOCHROMOCYTOMA

This report describes the case of a 38-year-old male with a no significant past medical history. The patient presented with the complaints of shortness of breath and episodic headache. In ER, his BP was 138/88 and physical examination was significant for lower lung field crackles and 1+ edema on dorsum of feet. His labs showed increased pro-NT BNP for 1328, CXR with mild to moderate pulmonary edema and cardiomegaly. Transthoracic echocardiogram showed EF of 25% with global hypokinesis. Administration of metoprolol succinate and lisinoprol, increased the systolic BP to 190 and secondary workup for hypertension showed increased plasma metanephrines which was subsequently confirmed by elevated 24-hour urine metanephrines. He had abdominal CT and MRI which showed mass in left adrenal gland. Elective left adrenalectomy yielded an adrenal gland mass which on biopsy confirmed pheochromocytoma.