Pheochromocytoma mimicking Takotsubo cardiomyopathy and hypertrophic cardiomyopathy: A cardiac magnetic resonance study

Gravina, Matteo; Casavecchia, Grazia; D’Alonzo, Natascja; Totaro, Antonio; Manuppelli, Vincenzo; Cuculo, Andrea; Vinci, Roberta; Macarini, Luca; Brunetti, Natale Daniele

doi:10.1016/j.ajem.2016.10.061

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…Because of the extreme similarities between two reported pheochromocytoma‐induced TS cases, one case which was reported later was excluded . In total, 156 cases reports (107 cases with PPGL‐induced TS, 42 cases epinephrine‐induced TS, and 7 cases norepinephrine‐induced TS) constitute the patient cohort for the meta‐analysis. Among the cases included were two non‐English case reports (one case in Swedish and one in German) where enough information could be obtained.…”

Section: Resultsmentioning

confidence: 99%

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Y‐Hassan

Falhammar

2020

Clinical Cardiology

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Innumerable physical stress factors including externally administered catecholamines, and pheochromocytomas and paragangliomas (PPGLs) have been reported to trigger Takotsubo syndrome (TS). A systematic search of PubMed/MEDLINE identified 156 patients with catecholamine-induced TS up to December 2017. Data were compared within the catecholamine-induced TS cohort, but some comparisons were also done to a previously published large all-TS cohort (n = 1750). The mean age was 46.4 ± 16.4 years (72.3% women). The clinical presentation was dramatic with high complication rates in (68.2%, n = 103; multiple complications 34.6%, n = 54). The most common TS ballooning pattern was apical or mid-apical (45.2%, n = 69), followed by basal pattern (28.8%, n = 45), global pattern (16.0%, n = 25), midventricular (8.3%, n = 13), focal (0.6%, n = 1), and unidentified pattern (1.9%, n = 3).There was an increase in the prevalence of apical sparing ballooning pattern compared to all-TS population (37.7% vs 18.3%, P < .00001). Higher complication rates were observed in TS with global ballooning pattern compared to apical ballooning pattern (23/25, 92% vs 38/65, 58.5%; P = .0022). Higher complication rates were observed in patients with age < 50 years than patients >50 years (73/92, 79.3% vs 29/56, 51.8%, P = 0.0009). Recurrence occurred exclusively in patients with PPGLinduced TS (18/107 patients, 16.8%). PPGL-induced TS was characterized by more global ballooning's pattern (22/104, 21.2% vs 3/49, 6.1%, P = 0.02), and lower left ventricular ejection fraction (25.54 ± 11.3 vs 31.82 ± 9.93, P = 0.0072) compared to exogenous catecholamine-induced TS. In conclusion, catecholamine-induced TS was characterized by a dramatic clinical presentation with extensive left ventricular dysfunction, and high complication rate. K E Y W O R D S broken heart syndrome, epinephrine, myocardial stunning, norepinephrine, paraganglioma, pheochromocytoma, Takotsubo

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Section: Resultsmentioning

confidence: 99%

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Y‐Hassan

Falhammar

2020

Clinical Cardiology

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“…Extracardiac mediastinal masses were also revealed with an accurate analysis of the relationship with the cardiac structures and of mediastinal adenopathy. A case of Takotsubo cardiomyopathy is noteworthy with an adrenal mass characterized by an intense enhancement at first pass; a pheochromocytoma was confirmed at following histological examination [ 15 , 16 ] ( Figure 5 ).…”

Section: Discussionmentioning

confidence: 99%

Incidental Extracardiac Findings and Their Characterization on Cardiac MRI

Gravina

Stoppino

Casavecchia

et al. 2017

BioMed Research International

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Background Cardiac magnetic resonance imaging (cMRI) has recently emerged as a new noninvasive imaging modality that offers superior structural and functional assessment of the heart. cMRI benefits from a large field of view but, consequently, may capture incidental extracardiac findings (IEFs). We aimed to evaluate the frequency and significance of IEFs reported from clinically indicated cMRI scans. Methods 742 consecutive patients (402 males and 340 females) referred to the Cardiac Magnetic Resonance Center of our University Hospital between January 2015 and December 2016 for clinically indicated cMRI were retrospectively enrolled for the evaluation of IEF prevalence and relevance. The median age of the subjects was 51 years (range: 5–85 years). Results A significant number of patients who underwent cMRI had incidental and clinically significant IEFs (2% of the population, 11.4% of cases). cMRI allowed a correct diagnosis in 116/131 cases with a diagnostic accuracy value of 88.5%. Conclusions IEFs on cMRI are not uncommon and lesions with mild or no clinical significance represent the most frequent findings. cMRI can characterize incidental findings with high accuracy in most cases.

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“…It is worth noting that CMR has been proposed as an invaluable tool in the diagnostic workup of atypical cases, such as this one. Gravina and colleagues 13 suggested that it may even allow diagnosing both stress cardiomyopathy and pheochromocytoma in a single imaging session.…”

Section: Discussionmentioning

confidence: 99%

Biventricular Takotsubo Cardiomyopathy as the Initial Manifestation of a Pheochromocytoma

Martínez¹,

Gallo-Bernal²,

Acosta³

et al. 2021

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Pheochromocytoma mimicking Takotsubo cardiomyopathy and hypertrophic cardiomyopathy: A cardiac magnetic resonance study

Cited by 12 publications

References 11 publications

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Incidental Extracardiac Findings and Their Characterization on Cardiac MRI

Biventricular Takotsubo Cardiomyopathy as the Initial Manifestation of a Pheochromocytoma

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