Pheochromocytoma Presenting as Takotsubo-Like Cardiomyopathy Following Delivery |
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| Institution: | 1. From the Department of Hypertension, Institute of Cardiology, Warsaw, Poland;2. From the Department of Congenital Heart Disease, Institute of Cardiology, Warsaw, Poland;3. From the Division of Internal Medicine and Diabetology, City Hospital, Włocławek, Poland;4. From the Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland;5. From the 2nd Neurological Department, Institute of Psychiatry and Neurology, Warsaw, Poland;6. From the Department of Molecular Biology, Institute of Cardiology, Warsaw, Poland;7. From the Institute of Laboratory Medicine & Clinical Chemistry and Department of Internal Medicine III, University Hospital, Technische Universität Dresden, Dresden, Germany;8. From the Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.;1. Departments of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Italy;2. Orthopedics, University Campus Bio-Medico of Rome, Italy;3. Hepatology, and Internal Medicine, University Campus Bio-Medico of Rome, Italy, and;5. Centre for Diabetes, The Blizard Building, Barts and The London School of Medicine, Queen Mary, University of London, London, United Kingdom.;1. Department of Endocrinology, Royal Free Hospital, London, United Kingdom;;2. Department of Cellular Pathology, University College Hospital, London, United Kingdom;;3. Centre for Endocrine Surgery University College Hospital and Great Ormond Street Hospital, London, United Kingdom;;4. Department of Radiology, University College Hospital, London, United Kingdom.;1. Dept. of Cardiology, Queen Elizabeth Hospital, University of Adelaide, Adelaide, SA 5000, Australia;2. Dept. of Respiratory Medicine, Basil Hetzel Institute, University of Adelaide, Adelaide, SA 5000, Australia;3. The Madison Practice, Suite 6, 25 Hunter St., Hornsby, NSW 2077, Australia |
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| Abstract: | ObjectiveDiagnosis of pheochromocytoma during pregnancy can be difficult, and the tumor carries an unfavorable prognosis if not diagnosed and treated in a timely manner.MethodsTo present a case of Takotsubo-like cardiomyopathy characterized by transient left ventricular apical ballooning due to pheochromocytoma following delivery.ResultsA few hours after Caesarean section, a 32-year-old Caucasian female presented with pulmonary edema followed by cardiac arrest with echocardiographic and ventriculographic evidence of reversible acute myocardial failure characteristic of Takotsubo-like cardiomyopathy. A previously unrecognized adrenal pheochromocytoma was found during her clinical work-up. Left ventricle (LV) function normalized after surgical removal of the tumor, which was carried out after implementing an alpha-adrenoreceptor blockade. Hemorrhagic necrosis of the pheochromocytoma was seen on histopathologic analysis; this may have triggered the sequence of events leading to the development of Takotsubo-like cardiomyopathy and hemodynamic collapse.ConclusionTo the best of our knowledge, this is the first reported case of Takotsubo-like cardiomyopathy related to pheochromocytoma following delivery. This emphasizes the increased cardiovascular risk if pheochromocytoma is not diagnosed and treated in a timely manner, especially during pregnancy. (Endocr Pract. 2014;20:e233-e236) |
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