Pheochromocytoma in a patient presenting with ventricular fibrillation and carotid dissection: a case report

Abstract

Background Pheochromocytoma is an endocrine tumour secreting catecholamines, most often revealed by clinical symptoms (headache, palpitations, diaphoresis, or resistant hypertension). Some cases of ventricular arrhythmias were described in the literature, without any formal link between arrhythmia and pheochromocytoma. Case summary We report a case of pheochromocytoma discovered after cardiac arrest due to ventricular fibrillation in a 46-year-old patient. The diagnosis was suggested by clinical symptoms (headache, palpitation, and diaphoresis) and suspected on the abdominal computed tomography scan. The diagnosis was corroborated by metaiodobenzylguanidine scintigraphy and finally confirmed by anatomopathological analysis of the operative specimen. The cerebral imaging showed a dissection of the left internal carotid artery and an intraparenchymal haematoma that might be secondary to a catecholaminergic discharge of phaeochromocytoma and severe hypertension. Discussion Since pheochromocytoma is accessible to curative treatment, its detection in case of cardiac arrest is essential to decrease the risk of arrhythmic recurrence.

Cardiac arrest as initial presentation of pheochromocytoma in a young

“…Identifying the biochemical phenotype of a pheochromocytoma is the first step in evaluating catecholamine-induced tachyarrhythmias and dysregulation of blood pressure. [1][2][3] Catecholamines bind with different affinities to adrenoceptors in multiple organs, including the heart and vasculature, leading to tachyarrhythmias and blood pressure changes. [4][5] Although cardiac β1-adrenoceptor stimulation by both norepinephrine and epinephrine causes tachyarrhythmias, the effect on the vasculature is determined by the distribution and affinities.…”