{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:01:11Z","timestamp":1780131671034,"version":"3.54.0"},"reference-count":20,"publisher":"IMR Press","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Aims\/Background: Phaeochromocytoma is a rare catecholamine-secreting neuroendocrine tumour arising from chromaffin cells of the adrenal medulla or from extra-adrenal paraganglionic tissue, in which case it is termed paraganglioma. Its clinical presentations are highly variable with up to 10\u201320% of patients being asymptomatic or having non-specific symptoms, therefore leading to frequent misdiagnosis. The aim of this case report is to present a rare and diagnostically challenging presentation as well as highlight the need to maintain a high index of suspicion in patients with unexplained cardiovascular symptoms. Case Presentation: A 54-year-old female presented with acute chest pain and atrial fibrillation, initially suggestive of acute coronary syndrome. However, coronary angiography demonstrated unobstructed coronary arteries, and electrocardiogram (ECG) changes resolved. Persistent symptoms and refractory hypertension prompted further investigation, which revealed a left adrenal mass and significantly elevated urinary metanephrines, consistent with a diagnosis of phaeochromocytoma. Results: After the diagnosis was confirmed by Endocrinology, treatment with phenoxybenzamine was initiated and titrated to 10 mg twice daily, resulting in stabilisation of her blood pressure and heart rate. Bisoprolol was added for further rate control. Following preoperative optimisation, the patient later underwent an uncomplicated laparoscopic adrenalectomy. At follow-up, she remained in sinus rhythm with a normalised blood pressure and resolution of symptoms. Conclusion: This case highlights the diagnostic challenge posed by phaeochromocytoma, which can mimic myocardial infarction and myocarditis due to catecholamine-induced cardiac effects.<\/jats:p>","DOI":"10.31083\/bjhm53981","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:09:42Z","timestamp":1780128582000},"source":"Crossref","is-referenced-by-count":0,"title":["More Than Myocarditis? Cardiac Involvement in Phaeochromocytoma\u2014A Case Report"],"prefix":"10.31083","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8349-5852","authenticated-orcid":true,"given":"Andrew Chisom","family":"Madu","sequence":"first","affiliation":[{"name":"Department of Medicine, Basildon University Hospital, Mid and South Essex NHS Foundation Trust, SS16 5NL Basildon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Beeton","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Peter\u2019s Hospital, Ashford and St. Peter\u2019s Hospitals NHS Foundation Trust, KT16 0PZ Chertsey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Lenders JWM, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, Grebe SKG, Murad MH, et al. 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Available at: https:\/\/www.britishpainsociety.org\/static\/uploads\/resources\/files\/pain_scales_eng.pdf (Accessed: 27 October 2025)."},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al. 2014 AHA\/ACC\/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology\/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation. 2014; 130: e199\u2013e267.","DOI":"10.1161\/CIR.0000000000000041"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"O\u2019Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA, et al. 2013 ACCF\/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines. Circulation. 2013; 127: e362\u2013e425.","DOI":"10.1161\/CIR.0b013e3182742cf6"},{"key":"ref9","unstructured":"British National Formulary (BNF). Phenoxybenzamine; Bisoprolol. BMJ Group and Pharmaceutical Press: London. 2025."},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Cheng Y, Ding N, Wang L, Qin L. A case report on pheochromocytoma mimicking as fulminant myocarditis-a diagnostic challenge. Frontiers in Cardiovascular Medicine. 2024; 11: 1326608.","DOI":"10.3389\/fcvm.2024.1326608"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Roghi A, Pedrotti P, Milazzo A, Bonacina E, Bucciarelli-Ducci C. Adrenergic myocarditis in pheochromocytoma. Journal of Cardiovascular Magnetic Resonance. 2011; 13: 4.","DOI":"10.1186\/1532-429X-13-4"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Zeng J, Yang T, Wang Y, Wu L. Massive pheochromocytoma causing adrenal crisis during surgery: a case report and review of the literature. Journal of Medical Case Reports. 2025; 19: 111.","DOI":"10.1186\/s13256-025-05153-x"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Prejbisz A, Lenders JWM, Eisenhofer G, Januszewicz A. Cardiovascular manifestations of phaeochromocytoma. Journal of Hypertension. 2011; 29: 2049\u20132060.","DOI":"10.1097\/HJH.0b013e32834a4ce9"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Ferreira AG, Nunes da Silva T, Alegria S, Cordeiro MC, Portugal J. Paraganglioma presenting as stress cardiomyopathy: case report and literature review. Endocrinology, Diabetes & Metabolism Case Reports. 2019; 2019: 19-0017.","DOI":"10.1530\/EDM-19-0017"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Martha JW, Prameswari HS, Munita FF, Kusumawardhani NY, Hasan M, Astuti A, et al. A multidisciplinary approach of a patient with pheochromocytoma presenting as recurrent acute fulminant myocarditis: A rare case report and comprehensive review of literature. 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