case_images: PMC10921470_01
case_images: Results of the ECG and coronary angiography. The ECG showed normal sinus rhythm and ST-segment elevations in leads II, III, aVF, and V2-V6 (a). A coronary angiography revealed no coronary stenosis (b-d).
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case_images: The electrocardiogram (ECG) revealed sinus rhythm with ST-segment elevation observed in leads II, III, aVF, and V2-V6 (Figure 1a), leading to a preliminary diagnosis of acute myocardial infarction (AMI). However, emergency coronary angiography revealed no coronary stenosis (Figure 1b-d) and an emergency cardiac ultrasound showed apical bulbous motion with an EF of 63% (Figure 2a), suggesting stress cardiomyopathy.
case_images: Results of echocardiography and adrenal gland CT scan. Echocardiography showed apical bulbous motion with an EF of 63% (a). CT scan of the adrenal gland revealed bilateral adrenal mass, with the left adrenal mass being larger in size (b-d).
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case_images: However, emergency coronary angiography revealed no coronary stenosis (Figure 1b-d) and an emergency cardiac ultrasound showed apical bulbous motion with an EF of 63% (Figure 2a), suggesting stress cardiomyopathy. Computerized tomography (CT) scan of the adrenal gland revealed a bilateral adrenal mass (left side size: 52.2 mm x 53.6 mm, right side size: 18.8 mm x 10.9 mm), with the left adrenal mass being larger in size after enhanced CT scan (Figure 2b-d).
case_images: Specimen from left adrenalectomy (a) and histopathological examination confirmed adrenal pheochromocytoma (b). Results of postoperative ECG and echocardiography (c and d).
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case_images: Finally, the patient underwent a successful laparoscopic left adrenalectomy (Figure 3a). Histopathological examination of the specimen confirmed the presence of adrenal pheochromocytoma (Figure 3b). In the postoperative examination, her creatine kinase isoenzyme was 19 U/L, troponin I was 0.056 ng/mL, and the ST of each ECG lead was lower than before (Figure 3c). An echocardiogram indicated weakened apical motion, but the remaining ventricular wall motion was not significantly abnormal at present, with an EF of 59% (Figure 3d).