case_images: PMC11004423_01
case_images: Electrocardiogram (ECG) findings. (A) The initial ECG conducted upon admission revealed ST-segment depression in leads II, III, AVF, and V3 to V6, along with T-wave inversions in leads II, AVF, and V4 to V6. (B) The ECG taken at discharge exhibited a normal sinus rhythm without significant abnormalities.
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case_images: F1
case_images: AVF and V4 to V6 (Figure 1A). The myocardial enzyme analysis showed significantly elevated levels of myoglobin (MYO, 284.04 ng/ml; normal 0-58 ng/ml), creatine kinase isoenzyme (CK-MB, 100 ng/L; normal 0-5 ng/ml), cardiac troponin-T (cTnT, 1,569 ng/L; normal 0-14 ng/L), as well as N-terminal pro-brain natriuretic peptide (NT-proBNP, 14,058 pg/ml; normal 0-300 pg/ml). Following the initiation of alpha-blockade therapy, the patient's condition gradually improved, with the normalization of various clinical and biochemical markers, improvement in left ventricular ejection fraction (50.8%), and resolution of ECG (Figure 1B) and radiological findings (Figure 2B).
case_images: Chest computed tomography (CT) scans. (A) The initial chest CT scan performed upon admission demonstrated bilateral pulmonary edema. (B) A repeat chest CT scan at discharge showed complete resolution of the previously noted pulmonary edema.
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case_images: F2
case_images: An echocardiogram showed diffuse left ventricular hypokinesia with a depressed ejection fraction of 26.9% along with mild mitral and tricuspid valve regurgitation. A chest computed tomography (CT) scan suggested bilateral pulmonary edema, potentially compounded by a lung infection (Figure 2A). Following the initiation of alpha-blockade therapy, the patient's condition gradually improved, with the normalization of various clinical and biochemical markers, improvement in left ventricular ejection fraction (50.8%), and resolution of ECG (Figure 1B) and radiological findings (Figure 2B).
case_images: (A) The contrast-enhanced abdominal CT scan identified a 26 x 26 x 25 mm mass located in the right adrenal gland, marked with blue arrows. (B) The postoperative follow-up CT scan revealed the complete excision of the tumor mass. (C) A photograph of the surgically removed tumor during the operation. (D) Microscopic examination of the adrenal gland tumor confirmed the diagnosis of pheochromocytoma.
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case_images: F3
case_images: At this point, a contrast-enhanced abdominal CT scan revealed a 26 x 26 x 25 mm mass in the right adrenal gland, leading to suspicion of pheochromocytoma (Figure 3A). Four weeks following alpha-blockade therapy, the patient underwent successful laparoscopic right adrenalectomy (Figures 3B,C), with the pathology report confirming adrenal pheochromocytoma (Figure 3D).