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Extra-adrenal pheochromocytoma presenting as inverse takotsubo-pattern cardiomyopathy treated with surgical resection
  1. Shima Tafreshi1,
  2. Syed Yaseen Naqvi2 and
  3. Sabu Thomas2
  1. 1 Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA
  2. 2 Department of Cardiology, University of Rochester Medical Center, Rochester, New York, USA
  1. Correspondence to Dr Syed Yaseen Naqvi, syedalinaqvi1{at}


Pheochromocytoma is a rare catecholamine-secreting tumour that is typically located in the adrenal medulla or along the sympathetic ganglia. The typical symptoms are episodic in nature and include tachycardia, sweating and headache. These tumours can present as transient, reversible cardiomyopathy similar to takotsubo cardiomyopathy (TCM). TCM is characterised by transient hypokinesis of the left ventricular apex and is typically induced by emotional stress. We describe the case of a 26-year-old woman with a medical history significant for headaches who presented initially to her family physician with nausea, vomiting, headache and hypertension. She was started on lisinopril 10 mg daily. One week later, she presented to the emergency department with substernal severe chest pressure. Her troponin level was elevated. Coronary angiogram showed normal coronary arteries and left ventriculogram showed inverse TCM pattern. Serum catecholamines were very elevated confirming pheochromocytoma. She was successfully treated with alpha-blockers followed by surgical resection.

  • hypertension
  • gastrointestinal surgery
  • mechanical ventilation
  • adrenal disorders
  • heart failure

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  • Patient consent for publication Obtained.

  • Contributors STa wrote the case report. SYN edited the case report. STh approved the final manuscript and was the physician responsible for patient care while in hospital.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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