Catecholamine cardiomyopathy associated with paraganglioma rescued by percutaneous cardiopulmonary support: inverted Takotsubo contractile pattern.
A case of catecholamine cardiomyopathy associated with paraganglioma, which was rescued by percutaneous cardiopulmonary support system (PCPS), is presented. Unlike typical apical ballooning, transthoracic echocardiography and left ventriculography revealed severe left ventricular (LV) dysfunction and an abnormal contractile pattern, consisting of akinesis of the basal and midventricular segments and hyperkinesis of the apical segments. Because of the intractable cardiogenic shock, despite conventional treatment, PCPS was performed. The underlying disease was paraganglioma. Catecholamine excess may induce not only transient LV apical ballooning but also atypical LV ballooning without involvement of the LV apex. Early use of PCPS is important for the patient with a catecholamine crisis who is not stabilized by intra-aortic balloon pump as well as infusion of fluid and inotropic agents.
Department of Internal Medicine, Cardiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Hyo Song
HS
Kim
Woo Ik
WI
Chang
Young Chan
YC
Kim
Seong Yoon
SY
Yi
Jae Sook
JS
Kil
Joo-Yong
JY
Hahn
Mira
M
Kang
Myung Shik
MS
Lee
Sang Hoon
SH
Lee
D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D002315:Cardiopulmonary Bypass; D002395:Catecholamines / Q000378:metabolism*; D003937:Diagnosis, Differential; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D010236:Paraganglioma, Extra-Adrenal / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D054549:Takotsubo Cardiomyopathy / Q000209:etiology* / Q000628:therapy*
D002395:Catecholamines