{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T18:22:21Z","timestamp":1779906141830,"version":"3.53.1"},"reference-count":11,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,4,22]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>We present a 52-year-old woman who was admitted to the emergency department with a short history of palpitations, sweating and nausea. An electrocardiogram (ECG) that was performed suggested inferolateral ischaemia with a significant troponin rise. The patient underwent an invasive coronary angiogram that showed mild non-obstructive coronary disease. She was thus given a provisional diagnosis of myocardial infarction with non-obstructive arteries (MINOCA), treated as an acute coronary syndrome (ACS) and subsequently discharged home. The patient represented within 72 hours with a recurrence of symptoms and a further troponin rise. While on the ward severe recurrent orthostatic hypertensive episodes were noted. Further investigations revealed increased urinary and plasma metanephrines, increased plasma catecholamines and imaging revealed a left adrenal 5.7\u2009cm mass, demonstrating probable pheochromocytoma. The patient was treated with curative surgery. This case highlights the importance of thorough history-taking in patients with atypical symptoms for acute coronary syndrome and diagnosed with MINOCA.<\/jats:p>","DOI":"10.1136\/bcr-2020-239761","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T12:14:48Z","timestamp":1624277688000},"page":"e239761","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Case of pheochromocytoma mimicking MINOCA"],"prefix":"10.1136","volume":"14","author":[{"given":"Loucia","family":"Karatzia","sequence":"first","affiliation":[{"name":"Cardiology Department, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"De Palma","sequence":"additional","affiliation":[{"name":"Cardiology Department, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"2025082700260633000_14.6.e239761.1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-134-4-200102200-00016"},{"key":"2025082700260633000_14.6.e239761.2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199101000-00004"},{"key":"2025082700260633000_14.6.e239761.3","doi-asserted-by":"crossref","first-page":"ehw149","DOI":"10.1093\/eurheartj\/ehw149","article-title":"Esc Working group position paper on myocardial infarction with non-obstructive coronary arteries","volume":"2","author":"Agewall","year":"2016","journal-title":"Eur Heart J"},{"key":"2025082700260633000_14.6.e239761.4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.011201"},{"key":"2025082700260633000_14.6.e239761.5","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu469"},{"key":"2025082700260633000_14.6.e239761.6","doi-asserted-by":"crossref","unstructured":"Melson E , Amir S , Shepherd L , et al . Myocardial infarction with non-obstructed coronaries \u2013 atypical presentation of pheochromocytoma. Endocrinol Diabetes Metab Case Rep 2019;2019.doi:10.1530\/EDM-19-0089","DOI":"10.1530\/EDM-19-0089"},{"key":"2025082700260633000_14.6.e239761.7","doi-asserted-by":"publisher","DOI":"10.1007\/BF03085991"},{"key":"2025082700260633000_14.6.e239761.8","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2016-214737","article-title":"Phaeochromocytoma presenting as an acute coronary syndrome","volume":"2016","author":"Imam","year":"2016","journal-title":"BMJ Case Rep"},{"key":"2025082700260633000_14.6.e239761.9","doi-asserted-by":"publisher","DOI":"10.4158\/EP11327.OR"},{"key":"2025082700260633000_14.6.e239761.10","unstructured":"Itani M , Mhlanga J . Imaging of Pheochromocytoma and Paraganglioma. In: Mariani-Costantini R, editor. Paraganglioma: A Multidisciplinary Approach [Internet]. Brisbane (AU): Codon Publications; 2019 Jul 2. Chapter 3. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK543223\/ [Accessed March 2021]."},{"key":"2025082700260633000_14.6.e239761.11","first-page":"3151","article-title":"Current diagnostic imaging of pheochromocytomas and implications for therapeutic strategy","volume":"15","author":"\u010ctvrtl\u00edk","year":"2018","journal-title":"Exp Ther Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-239761","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:26:12Z","timestamp":1756279572000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-239761"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":11,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,21]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/bcr-2020-239761"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-239761","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}