| Pheochromocytom A Cause of Stemi, Transient Left Venticular Dysfunction and Takotsubo Cardiomyopathy. | |
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MedLine Citation:
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PMID: 22441003 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Objective: To present a patient with a pheochromocytoma and apical left ventricular (LV) dysfunction that resolved after surgical resection of the pheochromocytoma, to review the effects of catecholamines on myocyte function and the concept that Takotsubo Cardiomyopathy (TC) is caused by excess catecholamines and to illustrate the difficulty in the management of an acute coronary syndrome during a hypertensive crisis due to a pheochromocytoma.Methods: We present the clinical history, physical findings, laboratory and imaging studies in a 60 year old gentleman with an acute coronary syndrome (ACS), TC and an incidentaloma later diagnosed to be a pheochomocytoma. The association with TC and the pertinent literature is reviewed.Results: A 60 year old man was suspected of having myocardial ischemia based on the symptoms of paroxysmal chest pain radiating to left shoulder, diaphoresis, ST segment elevation on EKG and elevated serial cardiac enzymes. Coronary angiography did not reveal significant coronary artery obstruction but detected ballooning of the apical, anterior and inferior wall consistent with TC. He had a history of labile hypertension and palpitations of three months duration. An adrenal mass in a prior CT scan and increased 24-hour catecholamine levels consistent with a pheochromocytoma. He was started on phenoxybenzamine and underwent a right adrenelectomy one month after this episode.Conclusion: Pheochromocytomas present with labile blood pressures and should be considered in the differential of acute coronary syndrome. This case also supports the concept that TC is caused by excess catecholamines. |
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Authors:
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Sheela Subramanyam; Robert Kreisberg |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-20 |
Journal Detail:
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Title: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists Volume: - ISSN: 1934-2403 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-3-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9607439 Medline TA: Endocr Pract Country: - |
Other Details:
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Languages: ENG Pagination: 1-11 Citation Subset: - |
Affiliation:
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Baptist Health System, PGY-2, 800 Montclair Road, Birmingham, AL-35213. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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