Catecholamine-induced cardiomyopathy in a patient with pheochromocytoma and polycystic kidney and liver disease: a case report

Sedaia, Ecaterina; Esanu, Andrei; Ivanov, Victoria; Carolina, Dumanschi; Моисеева, А. М.; Abraş, Marcel; Eugen, Calenici; Tatiana, Globa

doi:10.1093/ehjcr/ytz062

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…Due to intolerance, characterised by extreme hypotension, the patient found it difficult to continue the antihypertensive therapy. In contrast to the intolerance, she had frequent hypertensive crises every [3][4] 19 The ECG showed abnormalities like an acute coronary syndrome, but without troponin elevation in this case (Fig. 2).…”

Section: Case Reportmentioning

confidence: 69%

Catecholamine-induced cardiomyopathy - a clinical case

Vladimirova-Kitova¹,

Kitov²,

Uchikov³

et al. 2022

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A 27-year-old patient presented with a 3-month history of episodic headaches and persistently rising blood pressure (up to 240/120). The clinical, laboratory, and instrumental findings (episodes of severe hypertension, increased levels of metanephrine in urine, and MRI showing a mass of 5.1×5.5 cm in diameter) led us to the diagnosis of pheochromocytoma of the right adrenal grand. Preoperative medication included alpha blockers, calcium channel blockers, and plasma. The right adrenal gland was completely removed using the retroperitoneal access. During the extraction of the tumour, a ventricular tachycardia was recorded after which acute heart failure issued. In the first few hours, echocardiographic imaging showed a reduced EF of 9% – catecholamine-induced cardiomyopathy. The patient underwent a complex and adequate reanimation in the intensive care unit which lasted 20 days. A slow but steady increase in the ejection fraction along with a decrease in congestion was observed. Magnetic resonance imaging was used to confirm the normalisation of myocardial morphology. A German histological laboratory was used to confirm the benign form of the tumour. For the next three months, the patient was on a standard therapy with beta blockers, angiotensin-converting-enzyme inhibitor and mineralocorticoid antagonists. Тhe catecholamine surge during the removal of a large pheochromocytoma could lead to severe cardio-vascular complication, even with a complete and adequate preoperative protective medication. The reversibility of the process implies the necessity of an adequate and timely postoperative treatment for a complete involution of the pathomorphological changes.

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Section: Case Reportmentioning

confidence: 69%

Catecholamine-induced cardiomyopathy - a clinical case

Vladimirova-Kitova¹,

Kitov²,

Uchikov³

et al. 2022

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Catecholamine-induced cardiomyopathy: an endocrinologist’s perspective

Kumar¹,

Pappachan²,

Fernandez³

2021

Rev. Cardiovasc. Med.

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Although many endocrine diseases can be associated with acquired cardiomyopathy and heart failure, conditions except hypothyroidism, hyperthyroidism, phaeochromocytoma-paraganglioma (PPGL), and primary hyperaldosteronism are rare. PPGL is a rare catecholamine-secreting neuroendocrine tumour arising from the adrenal gland in 80–85% or extra-adrenal chromaffin cells of the autonomic neural ganglia in the remainder. The annual incidence of PPGL is 3–8 cases per million per year in the general population. Catecholamine-induced cardiomyopathy (CICMP) has got a prevalence of 8–11% among patients with PPGL. Hypertension, either sustained or episodic, is present in the vast majority (95%) of PPGL patients. However, among patients with CICMP, hypertension is present only in 65% of cases and the classical triad of paroxysmal headache, sweating, and palpitation is present only in 4%. Based on the cardiac remodelling in response to endogenous catecholamine excess, PPGL patients might present with one of the three CICMPs, including dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), or Takotsubo cardiomyopathy (TCM). Regardless of the subtypes, all CICMPs have many features in common — a dramatic clinical presentation, reversible cardiomyopathy, similar repolarisation electrocardiography changes, mild-moderate cardiac biomarker elevation, and normal coronary arteries on coronary angiography. CICMP should be suspected in patients with non-ischaemic, non-valvular forms of cardiomyopathy, even in those without definite features of catecholamine excess. PPGL associated TCM should be suspected in all acute coronary syndrome (ACS) patients exhibiting pronounced blood pressure variability with no culprit lesions on coronary angiography. This article will provide a review of the various CICMPs, their pathophysiology, clinical features, and the management options.

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Catecholamine-induced cardiomyopathy in a patient with pheochromocytoma and polycystic kidney and liver disease: a case report

Cited by 2 publications

References 12 publications

Catecholamine-induced cardiomyopathy - a clinical case

Catecholamine-induced cardiomyopathy - a clinical case

Catecholamine-induced cardiomyopathy: an endocrinologist’s perspective

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