Lin Pi Chi, Hsu Jen Te, Chung Chang Min, Chang Shih Tai
Division of Cardiology, Chia-yi Chang Gung Memorial Hospital, Pu-TZ City, Chai Yi Hsien 613, Taiwan, Republic of China.
Tex Heart Inst J. 2007;34(2):244-6.
We report the case of a 65-year-old man with a 6-year history of hypertension who presented with dilated cardiomyopathy, a transient cerebrovascular event, paroxysmal sweating, and intractable hypertension. Coronary angiography revealed no abnormality, but diagnostic testing was pursued because of the severe sweating and hypertension. Two-dimensional echocardiography showed 4-chamber dilatation with decreased left ventricular contractility. Further investigation, including a computed tomographic scan of the abdomen, led to a diagnosis of pheochromocytoma. Surgical resection of a left adrenal pheochromocytoma quickly resolved the patient's hypertension and resulted in substantially improved cardiac function after 4 months. Although pheochromocytoma has rarely been reported in the presence of both dilated cardiomyopathy and cerebrovascular events, it should be included in the differential diagnosis when patients present with dilated cardiomyopathy and a cerebrovascular event that have no obvious cause.
我们报告了一例65岁男性患者，有6年高血压病史，出现扩张型心肌病、短暂性脑血管事件、阵发性出汗和顽固性高血压。冠状动脉造影未发现异常，但由于严重出汗和高血压而进行了诊断性检查。二维超声心动图显示四腔扩大，左心室收缩力下降。进一步检查，包括腹部计算机断层扫描，最终诊断为嗜铬细胞瘤。手术切除左侧肾上腺嗜铬细胞瘤迅速缓解了患者的高血压，并在4个月后使心脏功能得到显著改善。尽管在同时存在扩张型心肌病和脑血管事件的情况下很少有嗜铬细胞瘤的报道，但当患者出现无明显病因的扩张型心肌病和脑血管事件时，应将其纳入鉴别诊断。
