Schiano P, Revel F, Barbou F, Guiraudet O, Lerecouvreux M, Monségu J
Service de cardiologie, HIA Val-de-Grâce, 74, boulevard Port-Royal, 75005 Paris, France.
Rev Med Interne. 2007 Dec;28(12):866-70. doi: 10.1016/j.revmed.2007.06.009. Epub 2007 Jun 26.
The role of catecholamines in the cardiac expression of pheochromocytoma is well-known. The physiopathology of the syndrome of Tako-tsubo remains more unclear.
We describe 2 clinical cases of acute coronary syndrome with left ventricular dysfunction and no coronary artery stenosis. The first, a syndrome of Tako-tsubo, also known as transient left ventricular apical ballooning syndrome, is characterized by transient wall-motion in the absence of obstructive epicardial coronary disease. The second is a pheochromocytoma with myocardial suffering during hypertension crisis. Through the similarities of these 2 observations, we discuss the physiopathological assumptions to explain the syndrome of Tako-tsubo by underlining the essential place of the catecholamine hypersecretion.
Syndrome of Tako-tsubo and pheochromocytoma are 2 distinct clinical entities. The link between these 2 affections is probably the pathogenic role in cardiac toxicity with the catecholamines.