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Initial presentation of pheochromocytoma with Takotsubo cardiomyopathy: a brief review of literature

Gujja, Karthik R; Aslam, Ahmed F; Privman, Vladimir; Tejani, Furqan; Vasavada, Balendu

Journal of Cardiovascular Medicine: January 2010 - Volume 11 - Issue 1 - p 49–52
doi: 10.2459/JCM.0b013e32832d862f
Case reports

Takotsubo cardiomyopathy, or transient left ventricular apical ballooning or broken heart syndrome, is characterized by excessive sympathetic stimulation induced acute coronary vasospasm. A 46-year-old female presented with polyuria and polydypsia and was diagnosed with new-onset diabetes mellitus, treated with insulin and intravenous fluids. During the hospital stay, she complained of an episode of left-sided chest pain and had mildly elevated cardiac enzymes. EKG showed new ST-segment elevation in V2, V3 leads without reciprocal changes. Her coronary angiogram showed no significant coronary artery stenosis, but severe systolic dysfunction and akinesis of the mid-anterior, anteroapical, mid-inferior and inferoapical segments. Further workup was negative except for plasma metanephrine being elevated. MRI of the abdomen showed a right adrenal mass consistent with pheochromocytoma. Surgical resection of the adrenal mass showed evidence of pheochromocytoma and the patient's symptoms were resolved.

Division of Cardiology, Department of Internal Medicine, Long Island College Hospital, Brooklyn, New York, USA

Received 6 February, 2009

Revised 27 April, 2009

Accepted 29 April, 2009

Correspondence to Dr Karthik R. Gujja, MD, MPH, Division of Cardiology, Department of Internal Medicine, Long Island College Hospital, 339 Hicks Street, Brooklyn, New York, USA. Tel: +1 646 584 6460; fax: +1 718 780 1300; e-mail: karthikgujja@gmail.com

© 2010 Italian Federation of Cardiology. All rights reserved.