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J Cardiovasc Med (Hagerstown). 2010 Jan;11(1):49-52. doi: 10.2459/JCM.0b013e32832d862f.

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

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  • 1Division of Cardiology, Department of Internal Medicine, Long Island College Hospital, Brooklyn, New York, USA. karthikgujja@gmail.com

Abstract

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.

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