Tagawa Minoru, Nanba Hitomi, Suzuki Hiromi, Nakamura Yuichi, Uchiyama Hiroko, Ochiai Sachie, Terunuma Masahiro, Yahata Kazuaki, Minamino Tohru
Department of Cardiology, Nagaoka Chuo General Hospital, Japan.
Intern Med. 2015;54(18):2343-9. doi: 10.2169/internalmedicine.54.4732. Epub 2015 Sep 15.
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.
一名33岁女性在医院发生了接近晕厥的情况。心电图显示有间歇性室性心律。入院时的超声心动图显示轻度运动减弱,次日出现严重弥漫性运动减弱及反向性应激性心肌病。患者入院当天出现腹痛,计算机断层扫描发现左肾上腺有一个大肿块。第三天她的儿茶酚胺水平显著升高。第12天时心肌运动改善。肿瘤成功切除,患者被诊断为异位嗜铬细胞瘤。反向性应激性心肌病所致的心肌损伤和低血压引起的室性心律掩盖了嗜铬细胞瘤的特征性症状。