Pheochromocytoma leading to Takotsubo and Ogilvie syndrome, a pathophysiological triad

Acta Cardiol. 2024 Apr;79(2):109-113. doi: 10.1080/00015385.2023.2268438. Epub 2023 Oct 12.

Abstract

Takotsubo syndrome (TTS) is a transient left ventricle dysfunction usually caused by a stressful trigger (emotional or physical). We report the case of a 77 year-old female patient who presented with TTS caused by a pheochromocytoma, a catecholamine-producing neuroendocrine tumour. Diagnosis was facilitated by acute kidney injury prompting renal ultrasound, recurrence of TTS and symptoms of episodic palpitations, profuse sweating and labile blood pressure. Furthermore, during her hospitalisation the patient also developed an Ogilvie syndrome, an acute colonic pseudo-obstruction, due to the catecholamine-excess. Treatment consisted of betablocker and angiotensin-converting enzyme inhibitor for TTS, neostigmine for Ogilvie syndrome, in combination with alpha-blocker and surgical removal of the tumour after recuperation of left ventricular function and colonic pseudo-obstruction. To our knowledge, this is the first case report of the pathophysiological triad of pheochromocytoma leading to Takotsubo and Ogilvie syndrome in a single patient.

Keywords: Takotsubo syndrome; acute colonic pseudo-obstruction; catecholamines; ogilvie syndrome; pheochromocytoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenal Gland Neoplasms* / complications
  • Adrenal Gland Neoplasms* / diagnosis
  • Adrenal Gland Neoplasms* / surgery
  • Aged
  • Catecholamines
  • Colonic Pseudo-Obstruction* / complications
  • Colonic Pseudo-Obstruction* / etiology
  • Female
  • Humans
  • Pheochromocytoma* / complications
  • Pheochromocytoma* / diagnosis
  • Pheochromocytoma* / surgery
  • Takotsubo Cardiomyopathy* / diagnosis
  • Takotsubo Cardiomyopathy* / etiology

Substances

  • Catecholamines