{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T01:13:07Z","timestamp":1755825187291,"version":"3.44.0"},"reference-count":20,"publisher":"Baishideng Publishing Group Inc.","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Cardiol"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n          <jats:p>Pheochromocytoma, a rare catecholamine-secreting tumor, typically presents with the classic triad of headache, palpitations, and diaphoresis, often accompanied by cardiovascular manifestations. While vomiting occurs in approximately 34.5% of cases, it is rarely the predominant and persistent presenting symptom. Pheochromocytoma-induced cardiomyopathy leading to heart failure is a recognized but uncommon complication. Due to its heterogeneous presentations, misdiagnosis and diagnostic delay are frequent.<\/jats:p>\n          <jats:p>CASE SUMMARY<\/jats:p>\n          <jats:p>A 53-year-old female presented predominantly with persistent and refractory vomiting as her chief complaint, accompanied by signs of acute heart failure [left ventricular ejection fraction (LVEF) 30%]. Initial evaluation at a primary hospital, including coronary angiography (revealing only mild stenosis), led to a misdiagnosis of coronary artery disease. Despite standard anti-thrombotic, anti-heart failure, and anti-emetic therapy, her vomiting persisted and heart failure did not resolve. Subsequent hospitalization revealed dramatic paroxysmal hypertension (202\/129 mmHg to 97\/51 mmHg) and fever. Significantly elevated plasma metanephrines and normetanephrine, combined with abdominal computed tomography and magnetic resonance imaging, confirmed a right adrenal pheochromocytoma. This diagnosis was significantly delayed due to the atypical prominence of gastrointestinal symptoms masking the underlying endocrine crisis.<\/jats:p>\n          <jats:p>CONCLUSION<\/jats:p>\n          <jats:p>This case highlights a highly atypical presentation of pheochromocytoma dominated by refractory vomiting and complicated by acute catecholamine-induced cardiomyopathy. It emphatically underscores that pheochromocytoma must be considered in the differential diagnosis for patients presenting with unexplained, treatment-resistant vomiting, particularly when co-existing with acute heart failure. The presence of labile hypertension, even if not initially evident, provides a crucial diagnostic clue. Prompt biochemical screening (catecholamine metabolites) and adrenal imaging are essential to prevent diagnostic delay and enable timely, life-saving surgical intervention.<\/jats:p>","DOI":"10.4330\/wjc.v17.i8.110366","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T03:24:29Z","timestamp":1755746669000},"source":"Crossref","is-referenced-by-count":0,"title":["Pheochromocytoma presenting with vomiting and heart failure: A case report"],"prefix":"10.4330","volume":"17","author":[{"given":"Han","family":"Cheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling-Tong","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2060","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"doi-asserted-by":"publisher","key":"B1","DOI":"10.1007\/s40618-022-01868-6"},{"doi-asserted-by":"publisher","key":"B2","DOI":"10.1016\/j.ando.2020.03.011"},{"doi-asserted-by":"publisher","key":"B3","DOI":"10.1016\/j.autneu.2013.01.007"},{"doi-asserted-by":"publisher","key":"B4","DOI":"10.1016\/j.phrs.2020.105124"},{"doi-asserted-by":"publisher","key":"B5","DOI":"10.1016\/j.lfs.2021.120106"},{"doi-asserted-by":"publisher","key":"B6","DOI":"10.1016\/j.tox.2016.10.004"},{"doi-asserted-by":"publisher","key":"B7","DOI":"10.1016\/j.biopha.2017.06.086"},{"doi-asserted-by":"publisher","key":"B8","DOI":"10.1007\/5584_2016_76"},{"doi-asserted-by":"publisher","key":"B9","DOI":"10.1016\/j.jamcollsurg.2009.09.022"},{"doi-asserted-by":"publisher","key":"B10","DOI":"10.1530\/eje.0.1500681"},{"doi-asserted-by":"publisher","key":"B11","DOI":"10.4158\/EP-2017-0057"},{"doi-asserted-by":"publisher","key":"B12","DOI":"10.2478\/enr-2019-0020"},{"doi-asserted-by":"publisher","key":"B13","DOI":"10.1210\/jc.2012-3020"},{"doi-asserted-by":"publisher","key":"B14","DOI":"10.1002\/ccr3.6"},{"doi-asserted-by":"publisher","key":"B15","DOI":"10.1530\/eje.0.1410619"},{"doi-asserted-by":"publisher","key":"B16","DOI":"10.1515\/enr-2017-0018"},{"doi-asserted-by":"publisher","key":"B17","DOI":"10.7759\/cureus.47063"},{"doi-asserted-by":"publisher","key":"B18","DOI":"10.29271\/jcpsp.2022.11.1483"},{"doi-asserted-by":"publisher","key":"B19","DOI":"10.47391\/JPMA.10839"},{"doi-asserted-by":"publisher","key":"B20","DOI":"10.1210\/clinem\/dgaa965"}],"container-title":["World Journal of Cardiology"],"original-title":[],"link":[{"URL":"https:\/\/www.wjgnet.com\/1949-8462\/full\/v17\/i8\/110366.htm","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.wjgnet.com\/1949-8462\/full\/v17\/i8\/110366.htm","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T03:27:30Z","timestamp":1755746850000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.wjgnet.com\/1949-8462\/full\/v17\/i8\/110366.htm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,26]]},"references-count":20,"journal-issue":{"issue":"8"},"alternative-id":["110366"],"URL":"https:\/\/doi.org\/10.4330\/wjc.v17.i8.110366","relation":{},"ISSN":["1949-8462"],"issn-type":[{"type":"print","value":"1949-8462"}],"subject":[],"published":{"date-parts":[[2025,8,26]]}}}