Pheochromocytoma presenting as takotsubo-like cardiomyopathy following delivery

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Katarzyna Jowik-Plebanek - , Cardinal Stefan Wyszynski Institute of Cardiology (Author)
  • Mariola Peczkowska - , Cardinal Stefan Wyszynski Institute of Cardiology (Author)
  • Anna Klisiewicz - , Cardinal Stefan Wyszynski Institute of Cardiology (Author)
  • Kazimierz Wrzesinski - , City Hospital (Author)
  • Aleksander Prejbisz - , Cardinal Stefan Wyszynski Institute of Cardiology (Author)
  • MacIej Niewada - , Medical University of Warsaw, Institute of Psychiatry and Neurology, Warszawa (Author)
  • Marek Kabat - , Cardinal Stefan Wyszynski Institute of Cardiology (Author)
  • Magorzata Szperl - , Cardinal Stefan Wyszynski Institute of Cardiology (Author)
  • Graeme Eisenhofer - , Institute of Clinical Chemistry and Laboratory Medicine, Department of Internal Medicine III (Author)
  • Jacques W. Lenders - , Institute for Clinical Chemistry and Laboratory Medicine, Department of Internal Medicine 3, Radboud University Nijmegen (Author)
  • Andrzej Januszewicz - , Cardinal Stefan Wyszynski Institute of Cardiology (Author)

Abstract

Diagnosis of pheochromocytoma during pregnancy can be difficult, and the tumor carries an unfavorable prognosis if not diagnosed and treated in a timely manner.Methods: To presenta case of Takotsubo-like cardiomyopathy characterized by transient left ventricular apical ballooning due to pheochromocytoma following delivery.Results: A 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 histopathologicanalysis; this may have triggered the sequence of events leading to the development of Takotsubo-like cardiomyopathy and hemodynamic collapse.Conclusion: To the best of our knowledge, this is the first reported case of Takotsubo-like cardiomyopathy related to pheochromocytomafollowing delivery. This emphasizes the increased cardiovascular risk if pheochromocytoma isnot diagnosed and treated in a timely manner, especially during pregnancy.

Details

Original languageEnglish
Pages (from-to)e233-e236
Journal Endocrine practice : American Association of Clinical Endocrinologists
Volume20
Issue number12
Publication statusPublished - 1 Dec 2014
Peer-reviewedYes

Keywords