Takotsubo syndrome and pheochromocytoma: an insidious combination

Autor: Stefano Maffè, Pierfranco Dellavesa, Paola Paffoni, Luca Bergamasco, Marisa Arrondini, Stefano Valentini, Emanuela Facchini, Eleonora Prenna, Lara Baduena, Giulia Careri, Nicolò Franchetti Pardo, Umberto Parravicini
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Monaldi Archives for Chest Disease (2021)
Druh dokumentu: article
ISSN: 1122-0643
2532-5264
DOI: 10.4081/monaldi.2021.1711
Popis: Pheochromocytoma is a rare adrenal tumor characterized by the secretion of catecholamines and vasoactive peptides. It can cause a catecholaminergic storm and lead to acute coronary syndromes. We present the case of a 53-year-old man, without any medical history, who arrived to the hospital following a spinal trauma due a fall. He presents back and retrosternal pain, with a clinical status of acute pulmonary edema, sinus tachycardia with left bundle branch block, left ventricular apical ballooning with depressed systolic function. Blood tests show a very important increase of Troponin and transaminases. A contrast chest-abdomen CT highlighted a right adrenal solid mass, with a diameter of 78mm, partial capsular laceration, compression of the inferior vena cava and the hepatic parenchyma. The clinical condition of the patient rapidly worsens from a respiratory and hemodynamic point of view, with cardiogenic shock, anuria and sepsis, refractory to all the medical treatments, until the patient died. The autopsy confirmed that the abdominal mass was a pheochromocytoma, broken after the trauma suffered. The resulting catecholaminergic storm caused a myocardial ischemia with Takotsubo syndrome, with cardiogenic shock. This unfortunate case confirms the pheochromocytoma as important risk factor for the onset of Takotsubo syndrome, and the how dramatic and severe a catecholaminergic storm can be.
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