A 53-year-old woman was admitted to the ICU with an acute onset of severe shortness of breath and chest discomfort. The symptoms started abruptly 12 hours prior, with palpitations and a sense of impending doom.
She reported episodes of headache, sweating, and tremors over the last month, but had ignored them. Medical history No prior cardiovascular disease No diabetes or hypertension No smoking or alcohol No family history of cardiac disease Physical examination HR: 128 bpm, irregular BP: 180/110 mmHg, labile Fine basal crackles, S3 gallop Mild peripheral edema Laboratory findings Troponin I mildly elevated (0.9 ng/mL) BNP: 2,000 pg/mL Electrolytes normal CBC normal ECG Echocardiography Global LV hypokinesia, EF 25% Coronary angiography No obstructive lesions Abdominal CT Left adrenal mass 4.5 cm Plasma metanephrines: markedly elevated Management provided so…
