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Atypical Takotsubo Cardiomyopathy Presenting As Acute Coronary Syndrome: A Case Report

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Specialty General Medicine
Date 2022 Oct 31
PMID 36312483
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Abstract

Background: Takotsubo cardiomyopathy (TS) is a rare acute cardiac disease with clinical features, symptoms, and electrocardiographic manifestations similar to those of acute myocardial infarction. We present the case of a patient with TS caused by a pheochromocytoma, which was confirmed by the postoperative pathology. Furthermore, we present the patient's subsequent management, treatment, and outcome.

Case Summary: A 64-year-old woman was admitted to the hospital with episodic chest pain and palpitations, electrocardiogram (ECG) findings suggestive of high lateral wall myocardial infarction, echocardiogram showing left ventricular wall segmental motion abnormalities, and elevated levels of the myocardial marker troponin. The patient underwent coronary angiography, which revealed unobstructed blood flow without obvious stenosis. During their hospitalization, the patient had paroxysmal elevation of blood pressure accompanied by palpitations and profuse sweating, with elevated blood catecholamine levels during seizures. Subsequent computerized tomography of the adrenal glands revealed the presence of a nodule in the right adrenal, which was resected and determined to be an adrenal pheochromocytoma. Therefore, the diagnosis of pheochromocytoma-induced atypical TS was made. The patient had an uneventful postoperative recovery.

Conclusion: Cardiologists should consider pheochromocytoma in patients with TS. Early detection allows timely intervention, benefiting patients.

Citing Articles

A case report and literature review: pheochromocytoma-mediated takotsubo cardiomyopathy, which is similar to acute myocardial infarction.

Zhang Z, Guo X, Wang J, Wang S, Wang Y Front Cardiovasc Med. 2023; 10:1194814.

PMID: 37424925 PMC: 10327548. DOI: 10.3389/fcvm.2023.1194814.

References
1.
Tofield A . Hikaru Sato and Takotsubo cardiomyopathy. Eur Heart J. 2016; 37(37):2812. DOI: 10.1093/eurheartj/ehw367. View

2.
Ueyama T, Hano T, Kasamatsu K, Yamamoto K, Tsuruo Y, Nishio I . Estrogen attenuates the emotional stress-induced cardiac responses in the animal model of Tako-tsubo (Ampulla) cardiomyopathy. J Cardiovasc Pharmacol. 2004; 42 Suppl 1:S117-9. DOI: 10.1097/00005344-200312001-00024. View

3.
Kido K, Guglin M . Drug-Induced Takotsubo Cardiomyopathy. J Cardiovasc Pharmacol Ther. 2017; 22(6):552-563. DOI: 10.1177/1074248417708618. View

4.
Lyon A, Bossone E, Schneider B, Sechtem U, Citro R, Underwood S . Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2015; 18(1):8-27. DOI: 10.1002/ejhf.424. View

5.
Y-Hassan S, Tornvall P . Epidemiology, pathogenesis, and management of takotsubo syndrome. Clin Auton Res. 2017; 28(1):53-65. PMC: 5805795. DOI: 10.1007/s10286-017-0465-z. View