Malignant Pheochromocytoma Presenting as Acute Coronary Syndrome: A Report of a Rare Case

Pheochromocytomas are rare tumors of the adrenal medulla. The classic presentation for this condition consists of a triad of symptoms: headache, tachycardia, and sweating in an episodic fashion. Rarely, pheochromocytomas are associated with cardiac pathology specifically acute coronary syndrome (ACS) and cardiomyopathy, which is usually attributed to catecholamine excess. They might also present secondary to elevations in blood pressure or arrhythmias. ECG changes are most often encountered as sinus tachycardia. We present a case of previously undiagnosed pheochromocytoma that showed up as ACS across multiple admissions in the setting of significant obstructive coronary artery disease. We aim to contribute to the growing literature reporting this uncommon presentation in order to showcase these cases to the medical audience.