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[急性循环衰竭合并肺水肿的罕见病因:嗜铬细胞瘤的儿茶酚胺能心肌病]

[A rare cause of acute circulatory failure with pulmonary edema: catecholergic cardiomyopathy of pheochromocytoma].

作者信息

Bossan S, Gibelin P, Bossan P, Fredenrich A, Blanc P, Richelme H, Morand P

机构信息

Service de Cardiologie, Hôpital Pasteur, Nice.

出版信息

Ann Cardiol Angeiol (Paris). 1990 Sep;39(7):417-21.

PMID:2264706
Abstract

We report the case of a 37 years old woman with pheochromocytoma of the adrenal gland, with acute circulatory failure and pulmonary oedema. Its originality lies, besides the rare circumstances of diagnosis, in the echographic aspect of the left ventricle with an apical myocardial infarction with both severe apical hypokinesia and compensating basal hyperkinesia. In the literature the most frequent aspect of catecholamine cardiomyopathy is a large uniform dilatation of the left ventricle with often wall hypertrophy. After surgical ablation of the left adrenal gland tumor, we observe quickly a complete normalisation of the picture and especially the echocardiogram. The cardiomyopathy and the pulmonary oedema can result from the specific action of the excess catecholamines on the myocardial cells and the pulmonary capillaries.

摘要

我们报告了一例37岁患有肾上腺嗜铬细胞瘤的女性病例,该患者伴有急性循环衰竭和肺水肿。其独特之处在于,除了诊断情况罕见外,左心室的超声心动图表现为心尖部心肌梗死,伴有严重的心尖部运动减弱和代偿性的基底段运动增强。在文献中,儿茶酚胺心肌病最常见的表现是左心室均匀性显著扩张,常伴有心室壁肥厚。在手术切除左肾上腺肿瘤后,我们很快观察到病情完全恢复正常,尤其是超声心动图表现。心肌病和肺水肿可能是由于过量儿茶酚胺对心肌细胞和肺毛细血管的特定作用所致。

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