Initial presentation of pheochromocytoma with Takotsubo cardiomyopathy: a brief review of literature.
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.
Division of Cardiology, Department of Internal Medicine, Long Island College Hospital, Brooklyn, New York, USA. karthikgujja@gmail.com
Karthik R
KR
Gujja
Ahmed F
AF
Aslam
Vladimir
V
Privman
Furqan
F
Tejani
Balendu
B
Vasavada
D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery; D000315:Adrenalectomy; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008676:Metanephrine / Q000097:blood; D008875:Middle Aged; D010673:Pheochromocytoma / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D016896:Treatment Outcome; D015854:Up-Regulation
D015415:Biomarkers; D008676:Metanephrine