title: Pheochromocytoma as a rare hidden cause of inverted stress cardiomyopathy.
abstract: Stress cardiomyopathy (SCMP) is characterized by a transient left ventricular dysfunction associated with apical ballooning and compensatory hyperkinesias of the basal segments after emotional or physical stress, but inverted or mid-ventricular variants of SCMP have also been described. Although catecholamine excess has been suggested as a possible pathophysiologic mechanism of SCMP, the etiology of SCMP is still unknown. Here, we report a case of inverted type of SCMP with clinical presentation mimicking acute coronary syndromes. The cause or precipitating stressor was unclear initially, but pheochromocytoma has been demonstrated as a cause of SCMP during clinical follow-up at out-patient clinic in the present case. Catecholamine-producing tumors should be included in the evaluation or management of SCMP, even though initial clinical manifestations are not suggestive for pheochromocytoma.
authors.affiliation: Department of Internal Medicine, Christian Hospital, Gwangju, Korea.
authors.forename: Soo Kyung
authors.initials: SK
authors.lastname: Cho
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Jae Yeong
authors.initials: JY
authors.lastname: Cho
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
keywords: Cardiomyopathy; Pheochromocytoma; Stress