J Korean Endocr Soc.  2009 Mar;24(1):47-53. 10.3803/jkes.2009.24.1.47.

A Case of Pheochromocytoma That Presented as Inverted Takotsubo Cardiomyopathy

• Cho M
• Shin IS
• Jin AR
• Park JB
• Noh HJ
• Kim HS
• Kim HY
• Park BH
• Cho CG
• Jeong JW

• KMID: 1468496
• DOI: http://doi.org/10.3803/jkes.2009.24.1.47

Abstract

A 52-year-old female was admitted to the hospital with abdominal pain. Her electrocardiogram revealed ST depressions in leads II, III, aVF and V2-5. The echocardiography showed transient cardiomyopathy with akinesia of the basal and mid portions of the left ventricle and hyperkinesia of the apex. There was no evidence of any vascular lesion on the emergency coronary angiography. She was diagnosed with pheochromocytoma by abdominal computed tomography and the post-operative pathologic examinations. These findings led us to a diagnosis of inverted Takotsubo cardiomyopathy related with pheochromocytoma. The recognition of such a rare cardiac manifestation should be considered in the diagnosis of pheochromocytoma, and especially in the circumstances of acute heart failure.

Keyword

pheochromocytoma; Takostubo cardiomyopathy

MeSH Terms

Abdominal Pain
Cardiomyopathies
Coronary Angiography
Depression
Echocardiography
Electrocardiography
Emergencies
Female
Heart Failure
Heart Ventricles
Humans
Hyperkinesis
Middle Aged
Pheochromocytoma
Takotsubo Cardiomyopathy

Figure

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  Fig. 1 The electrocardiogram revealed significant ST depression in leads II, III, aVF, and V2-V5 on admission day (A). The electrocardiogram revealed normal sinus rhythm with non-specific ST segment changes on 5th day (B).

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  Fig. 2 The transthoracic echocardiography showed akinesia of the basal and mid portion of left ventricle and hyperkinesia of the apex on admission day (A and B). Left ventricular abnormal wall movement was improved on the 6th day (C and D).

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  Fig. 3 The abdominal computed tomography showed a well-enhanced left adrenal mass (A). No significant stenosis was found on the coronary angiography (B and C). Histologic findings of left adrenal mass confirmed pheochromocytoma (D).

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