[MINOCA revealing an anomalous origin of right coronary artery and a pheochromocytoma : A case report with literature review].

Pheochromocytoma is a rare secretory neuroendocrine tumor of the adrenal medulla, which usually presents with Ménard's triad or high blood pressure. Its diagnosis is based on elevated adrenaline and noradrenaline levels. Cross-sectional imaging, such as computed tomography or magnetic resonance imaging highlights the tumor and management consists of excision of this tumor. Cardiovascular complications of pheochromocytoma are multiple, such as rhythm disturbances, hypotension, shock, acute coronary syndromes, transient ischemic attacks and cerebrovascular accidents. Thus, in the face of acute coronary syndromes manifested by (1) typical chest pain associated with (2) an electrocardiogram in favor of persistent ST segment elevation (STEMI) or non-persistent ST segment elevation (NSTEMI), (3) an elevation of cardiac necrosis markers and (4) a coronary angiography revealing normal coronary arteries or without significant stenosis, a myocardial infarction with angiographically non obstructed coronary arteries (MINOCA) is confirmed. Certain etiologies of MINOCA such as cardiomyopathies induced by Takotsubo, myocarditis and catecholamines are currently clearly identified, have been able to explain the link between Minoca and pheochromocytoma [1]. Although a few cases of MINOCA revealing a pheochromocytoma have been reported, anomalous origin of coronary artery remains an exceptional cause of MINOCA. We report a case of myocardial infarction with angiographically normal coronary arteries revealing both an anomalous origin of right coronary artery and a pheochromocytoma, which, to our knowledge, appears to be the first described in the literature.