A systematic cohort review of pheochromocytoma-induced typical versus atypical Takotsubo cardiomyopathy

Recurrent Takotsubo Cardiomyopathy due to Pheochromocytoma Managed With Venoarterial Extracorporeal Membrane Oxygenation

“…This hypothesis is mainly supported by case reports and series where patients underwent a major emotional event or stressor (most commonly women of an average 65 to 70 years of age), including those requiring administration of catecholamines as treatment or those involving catecholamine-producing masses. The exact mechanism of excessive catecholamine-induced myocardial injury is not clear; however, suggested mechanisms include microcirculation dysfunction, spasm of multiple epicardial vessels, plaque rapture and direct catecholamine-induced cardiotoxicity on cardiomyocytes [ 4 , 9 ].…”

“…Despite extensive speculation, the pathophysiology of TC remains unclear [ 3 ]. Pheochromocytoma-induced Takotsubo cardiomyopathy (PiTC) has been described in the literature as a rare and often life-threatening severe cardiomyopathy, due to its rather usual complication with cardiogenic shock and no single pattern of ventricular dysfunction [ 4 ].…”

A case report and literature review: pheochromocytoma-mediated takotsubo cardiomyopathy, which is similar to acute myocardial infarction

“…Chest pain is the most common symptom in Pheo-TCM patients, followed by dyspnoea (11). Some patients also experience symptoms of pheochromocytoma such as headache, palpitation, diaphoresis and hypertension, but all these findings were significantly lower than pheochromocytoma alone (12).…”

“…The complication rate is higher (about three times that of all-TCM)), including heart failure, pulmonary edema, cardiogenic shock (CS), circulatory respiratory failure and apical thrombus formation (14,15). Due to these complications, the mortality rate of Pheo TCM is high (over 5%) (11). The patient's initial symptoms related to pheochromocytoma were also atypical, indicating that the onset of Pheo-TCM was more insidious.…”

“…Avelyn Aw et al analyzed 51 Pheo-TCM patients, of which 35 had elevated plasma (nor)metanephrines levels. 16 patients with negative plasma (nor)metanephrines were diagnosed due to elevated urine(nor) metanephrines (n = 5) or urine catecholamines (n = 11) (11). Patients with positive biochemical results should be further examined by imaging to locate the tumor.…”