Initial presentation of pheochromocytoma with Takotsubo cardiomyopathy: a brief review of literature

J Cardiovasc Med (Hagerstown). 2010 Jan;11(1):49-52. doi: 10.2459/JCM.0b013e32832d862f.

Abstract

Takotsubo cardiomyopathy, or transient left ventricular apical ballooning or broken heart syndrome, is characterized by excessive sympathetic stimulation induced acute coronary vasospasm. A 46-year-old female presented with polyuria and polydypsia and was diagnosed with new-onset diabetes mellitus, treated with insulin and intravenous fluids. During the hospital stay, she complained of an episode of left-sided chest pain and had mildly elevated cardiac enzymes. EKG showed new ST-segment elevation in V2, V3 leads without reciprocal changes. Her coronary angiogram showed no significant coronary artery stenosis, but severe systolic dysfunction and akinesis of the mid-anterior, anteroapical, mid-inferior and inferoapical segments. Further workup was negative except for plasma metanephrine being elevated. MRI of the abdomen showed a right adrenal mass consistent with pheochromocytoma. Surgical resection of the adrenal mass showed evidence of pheochromocytoma and the patient's symptoms were resolved.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenal Gland Neoplasms / complications*
  • Adrenal Gland Neoplasms / diagnosis
  • Adrenal Gland Neoplasms / metabolism
  • Adrenal Gland Neoplasms / surgery
  • Adrenalectomy
  • Biomarkers / blood
  • Coronary Angiography
  • Electrocardiography
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Metanephrine / blood
  • Middle Aged
  • Pheochromocytoma / complications*
  • Pheochromocytoma / diagnosis
  • Pheochromocytoma / metabolism
  • Pheochromocytoma / surgery
  • Takotsubo Cardiomyopathy / diagnosis
  • Takotsubo Cardiomyopathy / etiology*
  • Takotsubo Cardiomyopathy / metabolism
  • Treatment Outcome
  • Up-Regulation

Substances

  • Biomarkers
  • Metanephrine