Pheochromocytoma-Induced Takotsubo Cardiomyopathy

Tex Heart Inst J. 2019 Apr 1;46(2):124-127. doi: 10.14503/THIJ-17-6407. eCollection 2019 Apr.

Abstract

Pheochromocytoma, a rare catecholamine-secreting tumor, typically manifests itself with paroxysmal hypertension, tachycardia, headache, and diaphoresis. Less often, symptoms related to substantial hemodynamic compromise and cardiogenic shock occur. We report the case of a 66-year-old woman who presented with abdominal pain. Examination revealed a large right adrenal mass, cardiogenic shock, and severe heart failure in the presence of normal coronary arteries. Within days, the patient's hemodynamic status and left ventricular ejection fraction improved markedly. Results of imaging and biochemical tests confirmed the diagnosis of pheochromocytoma-induced takotsubo cardiomyopathy. Medical therapy and right adrenalectomy resolved the patient's heart failure, and she was asymptomatic postoperatively. We recommend awareness of the link between pheochromocytoma and takotsubo cardiomyopathy, and we discuss relevant diagnostic and management principles.

Keywords: Adrenal gland neoplasms/complications; cardiomyopathies/diagnosis/etiology/therapy; catecholamines; pheochromocytoma/complications/physiopathology; shock, cardiogenic/etiology; takotsubo cardiomyopathy/etiology; treatment outcome.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Gland Neoplasms / complications*
  • Adrenal Gland Neoplasms / diagnosis
  • Adrenal Gland Neoplasms / surgery
  • Adrenalectomy
  • Aged
  • Diagnosis, Differential
  • Electrocardiography
  • Female
  • Humans
  • Magnetic Resonance Imaging, Cine / methods
  • Pheochromocytoma / complications*
  • Pheochromocytoma / diagnosis
  • Pheochromocytoma / surgery
  • Takotsubo Cardiomyopathy / diagnosis
  • Takotsubo Cardiomyopathy / etiology*
  • Tomography, X-Ray Computed / methods