RESUMO
A 61-year-old woman was admitted to the emergency department with acute chest pain. Echocardiography showed transient cardiomyopathy with akinesia of the basal and midportions of the left ventricle and hyperkinesia of the apex. No evidence of ischemic cardiomyopathy on myocardial SPECT or ergonovine stress echocardiography was observed. The patient's condition at discharge had improved, but she later was diagnosed as having pheochromocytoma. The findings of transient cardiomyopathy revealed inverted Takotsubo cardiomyopathy related to pheochromocytoma. The recognition of such a rare cardiac manifestation should be considered in the diagnosis of pheochromocytoma.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Cardiomiopatias , Dor no Peito , Ecocardiografia , Ecocardiografia sob Estresse , Emergências , Ergonovina , Ventrículos do Coração , Hipercinese , Feocromocitoma , Cardiomiopatia de Takotsubo , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
Stress-induced cardiomyopathy, known as Takotsubo cardiomyopathy, is a newly described clinical entity characterized by transient left ventricular apical ballooning and left ventricular apical dyskinesis, with no significant stenosis on the coronary angiogram. We describe a patient who had transient cardiomyopathy with akinesia of the basal portions of the left ventricle and hyperkinesia of the apex. This is the first case of stress-induced cardiomyopathy with an "inverted Takotsubo" contractile pattern triggered by emotional stress in Korea. The cause of stress-induced cardiomyopathy is unclear, but catecholamines probably play a role in this syndrome. This entity could provide clues to the pathophysiology underlying stress-induced cardiomyopathy.