title: Acute systolic heart failure and uncontrolled hypertension: what is the missing link?
abstract: Pheochromocytoma is a rare tumor in adults, with an estimated annual incidence of 0.8 per 100,000 persons. Cardiomyopathy is an uncommon presentation of such a rare disease. Serious cardiovascular complications of these tumors are related to potent effects of secreted catecholamines. The mechanism of pheochromocytoma-related cardiomyopathy is not well understood but it is likely due to the effect of excess catecholamines and their oxidation products which have been found to have a direct toxic effect on the myocardium. We describe below a case of a 70-year old female with uncontrolled hypertension and new onset acute systolic heart failure, who on further evaluation was noted to have pheochromocytoma-related cardiomyopathy. Pheochromocytoma should be strongly considered in the differential diagnosis of non-ischemic cardiomyopathy for a patient with elevated blood pressures relative to severity of cardiac dysfunction.
authors.affiliation: a Department of Internal Medicine , Guthrie Clinic , Sayre , PA , USA.
authors.forename: Marcelle G
authors.initials: MG
authors.lastname: Meseeha
authors.affiliation: b Department of Cardiology , Guthrie Clinic , Sayre , PA , USA.
authors.forename: Sudhakar
authors.initials: S
authors.lastname: Sattur
mesh_terms: D000208:Acute Disease; D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D009202:Cardiomyopathies / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D002395:Catecholamines / Q000097:blood; D004351:Drug Resistance; D005260:Female; D054143:Heart Failure, Systolic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D002395:Catecholamines
keywords: Pheochromocytoma; acute systolic heart failure; hypertension; myocardial stunning