[A false diagnosis of hypertrophic myocardiopathy in pheochromocytoma].
A 24 year-old man was admitted with hypertensive crises and diagnosis hypothesis of neurofibromathosis and pheochromocytoma with blood pressure of 150 x 110mmHg and in use of anti-hypertensive drugs. The electrocardiogram (EKG) showed left ventricle hypertrophy. An echocardiogram showed interventricular septum (IVS) thickness of 16mm, posterior wall (PW) thickness of 11mm (ratio IVS/PW was 1.4). Diastolic ventricular diameter was 39mm with gradient of 52mmHg and mild mitral-valve murmur by pulsate Doppler. Increased vanillylmandelic acid and metanephrines in a 24-hour sample of urine has confirmed diagnosis of pheochromocytoma within was localized by 131I metaiodobenzyl-guanidine scan and computerized axial tomography. The patient was submitted to right adrenalectomy. Blood pressure was normalized. Evaluation an year later revealed a healthy man with normal laboratory exams, EKG and echocardiogram. It seems that the hypertrophy was consequence of the hypertension and pheochromocytoma, was not hypertrophic cardiomyopathy.
Lopes
H F
HF
Instituto do Coração do Hospital das Clínicas - FMUSP.
Silva
H B
HB
Frimm
C de C
Cde C
Bortolotto
L A
LA
Belotti
G
G
Pileggi
F
F
D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D003951:Diagnostic Errors; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000175:diagnosis*; D008297:Male; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis*; D011379:Prognosis
Falso diagnóstico de miocardiopatia hipertrófica em feocromocitoma.