Takotsubo syndrome and pheochromocytoma: an insidious combination

https://doi.org/10.4081/monaldi.2021.1711

Authors

  • Stefano Maffè | stemaffe@libero.it Division of Cardiology, SS Trinità Borgomanero Hospital, Italy. https://orcid.org/0000-0002-1007-5570
  • Pierfranco Dellavesa Division of Cardiology, SS Trinità Borgomanero Hospital, Italy.
  • Paola Paffoni Division of Cardiology, SS Trinità Borgomanero Hospital, Italy.
  • Luca Bergamasco Division of Cardiology, SS Trinità Borgomanero Hospital, Italy.
  • Marisa Arrondini Division of Surgical Pathology, SS Trinità Borgomanero Hospital, Italy.
  • Stefano Valentini Division of Pathology, SS Trinità Borgomanero Hospital, ASL NO, Novara., Italy.
  • Emanuela Facchini Division of Cardiology, SS Trinità Borgomanero Hospital, ASL NO, Novara., Italy.
  • Eleonora Prenna Division of Cardiology, SS Trinità Borgomanero Hospital, ASL NO, Novara., Italy.
  • Lara Baduena Division of Cardiology, SS Trinità Borgomanero Hospital, ASL NO, Novara., Italy.
  • Giulia Careri Division of Cardiology, SS Trinità Borgomanero Hospital, Italy.
  • Nicolò Franchetti Pardo Division of Cardiology, SS Trinità Borgomanero Hospital, ASL NO, Novara., Italy.
  • Umberto Parravicini Division of Cardiology, SS Trinità Borgomanero Hospital, ASL NO, Novara., Italy.

Abstract

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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References

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Published
2021-03-09
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Cardiology - Case Reports
Keywords:
Takotsubo syndrome, pheochromocytoma
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How to Cite
Maffè, Stefano, Pierfranco Dellavesa, Paola Paffoni, Luca Bergamasco, Marisa Arrondini, Stefano Valentini, Emanuela Facchini, Eleonora Prenna, Lara Baduena, Giulia Careri, Nicolò Franchetti Pardo, and Umberto Parravicini. 2021. “Takotsubo Syndrome and Pheochromocytoma: An Insidious Combination”. Monaldi Archives for Chest Disease, March. https://doi.org/10.4081/monaldi.2021.1711.