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.
Gujja
Karthik R
KR
Division of Cardiology, Department of Internal Medicine, Long Island College Hospital, Brooklyn, New York, USA. karthikgujja@gmail.com
Aslam
Ahmed F
AF
Privman
Vladimir
V
Tejani
Furqan
F
Vasavada
Balendu
B
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