Pheochromocytoma can present atypically with ventricular rhythm, myocardial damage, and hypotension induced by reverse takotsubo cardiomyopathy, which may mask its characteristic symptoms.
Supports pheochromocytoma evaluation in atypical reverse takotsubo with arrhythmias; leaves open whether screening alters outcomes.
A 33-year-old woman experienced near-syncope at a hospital. Electrocardiography revealed an intermittent ventricular rhythm. The echocardiogram at admission indicated mild hypokinesis and severe diffuse hypokinesis with reverse takotsubo cardiomyopathy on the following day. The patient experienced abdominal pain on the admission day, and computed tomography identified a large left adrenal mass. Her catecholamine levels increased remarkably on the third day. The wall motion improved on the twelfth day. The tumor was successfully resected and the patient was diagnosed with an ectopic pheochromocytoma. The ventricular rhythm with myocardial damage and hypotension induced by the reverse takotsubo cardiomyopathy masked the characteristic symptoms of pheochromocytoma.
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Tagawa et al. (2015) studied this question.
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