title: Tako-tsubo cardiomyopathy precipitated by pheochromocytoma crisis.
abstract: We report the case of a 69 year-old Chinese lady with pheochromocytoma who developed chest pain and acute ST-segment elevation in the anterior leads on electrocardiography. She was given intravenous phenoxybenzamine for alpha-blockade before undergoing urgent coronary angiography. This revealed minor coronary artery disease. Left ventriculogram demonstrated akinesis in the apex with hypercontraction of the basal segments. The Tako-tsubo cardiomyopathy eventually resolved with surgical removal of the pheochromocytoma. This case highlights the challenging management of suspected acute myocardial infarction in pheochromocytoma crisis and also reinforces the notion that Tako-tsubo cardiomyopathy is likely precipitated by catecholamine excess.
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore. chia1@singnet.com.sg
authors.forename: Pow-Li
authors.initials: PL
authors.lastname: Chia
authors.forename: David
authors.initials: D
authors.lastname: Foo
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000315:Adrenalectomy; D018674:Adrenergic Antagonists / Q000627:therapeutic use; D000368:Aged; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis; D010673:Pheochromocytoma / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D011237:Predictive Value of Tests; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D018674:Adrenergic Antagonists