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

Figures

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  Figure 1. (A) ECG of the admitted patient; (B) ECG of patients after treatment with phenoxybenzamine. (C) Lung CT examination at admission shows that bronchiectasis of the lower lobe of the left lung is associated with infection, bilateral lung inflammation (red arrow). (D) Pulmonary CT on the second day after the addition of phenbenamine, displays Bronchiectasis of the lower lobe of the left lung with slight relief of infection (red arrow). (E) Preoperative lung CT re-examination depicts that the degree of bronchiectasis with infection in the lower lobe of the left lung is slightly less than that of the previous one (red arrow). (F) Abdominal enhanced CT manifests that mass high density mixed density shadow can be observed in the left middle and upper abdomen; the maximum level is about 7.7 cm × 9.4 cm (red arrow). (G) Preoperative abdominal CT review, appearing roughly similar to the previous image (red arrow). (H) Systolic period in the apical two chamber (A2C) view: displays the apical wall of left ventricle becomes thinner; outward bulg and reduction of amplitude of motion (red arrow).

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  Figure 2. Phenoxybenzamine was used from the 7th day. The red arrow indicates the start of the treatment with phenoxybenzamine, and the black arrow indicates the increase of the dosage of phenoxybenzamine. (A) White blood cell count. (B) procalcitonin count. (C) Blood urea nitrogen and creatinine levels. (D) Liver function tests, aspartate transaminase, and alkaline phosphatase. (E) Daily maximum temperature. (F) Daily maximum systolic and diastolic blood pressure. (G) Heart rate.

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  Figure 3. Pathological image. (A) HE staining of pheochromocytoma; the tumor is positive for chromogranin-A (B) and synaptophysin (C); S100 shows a well-developed sustentacular cell network (D); The nontumorous elements (e.g. endothelial cells, stromal cells, etc.); SDHB remains positive (E); Ki67 (+2%) (F). Pheochromocytoma is positive for SF-1 (G) and CK-pan (H).