{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:06:56Z","timestamp":1760234816600,"version":"build-2065373602"},"reference-count":10,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>We present the case of a 45-year-old woman admitted to our unit with acute heart failure and cardiogenic shock, requiring an intra-aortic balloon pump insertion and inotropes and vasopressors infusion. Despite such treatment, the patient developed multi organ failure and intravascular disseminated coagulation with haemolysis. The initial diagnosis of acute myocarditis was subsequently denied by the finding of bilateral adrenal masses by MRI scan, and urine and plasma metanephrines measurements confirmed a pheochromocytoma (PCC). Genetic analysis revealed a mutation in the neurofibromatosis type 1 (NF1) gene, and an accurate physical examination drew attention to small caf\u00e8-au-lait spots, usually associated with this syndrome. PCC diagnosis should be promptly considered in patients presenting with unexplained acute heart failure and cardiogenic shock of unknown origin, considering its life-threatening complications and the good prognosis after radical surgery.<\/jats:p>","DOI":"10.3390\/jcdd8060071","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T11:00:33Z","timestamp":1623754833000},"page":"71","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cNever Trust to General Impressions, My Boy, but Concentrate Yourself upon Details\u201d: An Unusual and Challenging Presentation of Pheochromocytoma"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7082-4262","authenticated-orcid":false,"given":"Umberto","family":"Barbero","sequence":"first","affiliation":[{"name":"Division of Cardiology, \u201cSantissima Annunziata\u201d Hospital, 12038 Savigliano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Matta","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Hospital \u201cSant\u2019Andrea\u201d of Vercelli, 13100 Vercelli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6930-7073","authenticated-orcid":false,"given":"Mirko Parasiliti","family":"Caprino","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, \u2018Citt\u00e0 della Salute e della Scienza\u2019 Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Maletta","sequence":"additional","affiliation":[{"name":"Division of Pathology, Department of Laboratory Medicine, \u2018Citt\u00e0 della Salute e della Scienza\u2019 Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Giraudo","sequence":"additional","affiliation":[{"name":"Division of General Surgery 1, Department of Surgery, \u2018Citt\u00e0 della Salute e della Scienza\u2019 Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Frea","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Clinical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"De Benedictis","sequence":"additional","affiliation":[{"name":"Division of Cardiology, \u201cSantissima Annunziata\u201d Hospital, 12038 Savigliano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Maccario","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, \u2018Citt\u00e0 della Salute e della Scienza\u2019 Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e138","DOI":"10.1016\/j.ijcard.2008.03.012","article-title":"Pheochromocytoma Crisis Presenting with Shock and Tako-Tsubo-Like Cardiomyopathy","volume":"134","author":"Lassnig","year":"2009","journal-title":"Int. J. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"596354","DOI":"10.1155\/2011\/596354","article-title":"Pheochromocytoma Presenting as Acute Heart Failure Leading to Cardiogenic Shock and Multiorgan Failure","volume":"2011","author":"Steppan","year":"2011","journal-title":"Case Rep. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"507","DOI":"10.2459\/JCM.0b013e32832b4ccc","article-title":"Cardiogenic Shock with Basal Transient Left Ventricular Ballooning (Takotsubo-Like Cardiomyopathy) sa First Presentation of Pheochromocytoma","volume":"11","author":"Daniele","year":"2010","journal-title":"J. Cardiovasc. Med."},{"key":"ref_4","first-page":"1065","article-title":"Cardiomyopathy: First Clinical Manifestation of a Pheochromocytoma\u2014Case Report","volume":"29","author":"Lopes","year":"2010","journal-title":"Rev. Port. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1055\/s-0030-1253413","article-title":"Sepsis and Cardiomyopathy as Rare Clinical Manifestations of Pheochromocytoma\u2014Two Case Report Studies","volume":"118","author":"Tanriver","year":"2010","journal-title":"Exp. Clin. Endocrinol. Diabetes"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.amjmed.2006.08.031","article-title":"Rapidly Reversible Cardiogenic Shock as a Pheochromocytoma Presentation","volume":"120","author":"Brukamp","year":"2007","journal-title":"Am. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1093\/eurheartj\/ehl570","article-title":"Tako-Tsubo Cardiomyopathy: Intraindividual Structural Analysis in the Acute Phase and After Functional Recovery","volume":"28","author":"Nef","year":"2007","journal-title":"Eur. Heart J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1007\/s11897-014-0196-6","article-title":"Management of Fulminant Myocarditis: A Diagnosis in Search of Its Etiology but with Therapeutic Options","volume":"11","author":"Maisch","year":"2014","journal-title":"Curr. Heart Fail. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1136\/jmg.2006.045906","article-title":"Guidelines for the Diagnosis and Management of Individuals with Neurofibromatosis 1","volume":"44","author":"Ferner","year":"2007","journal-title":"J. Med. Genet."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2729","DOI":"10.1056\/NEJMc066006","article-title":"European-American Pheochromocytoma Study Group. Clinical and Genetic Characteristics of Patients with Neurofibro-Matosis Type 1 and Pheochromocytoma","volume":"354","author":"Bausch","year":"2006","journal-title":"N. Engl. J. Med."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/8\/6\/71\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:14:18Z","timestamp":1760163258000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/8\/6\/71"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,15]]},"references-count":10,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["jcdd8060071"],"URL":"https:\/\/doi.org\/10.3390\/jcdd8060071","relation":{},"ISSN":["2308-3425"],"issn-type":[{"type":"electronic","value":"2308-3425"}],"subject":[],"published":{"date-parts":[[2021,6,15]]}}}