Itagane Masaki, Nakazato Jun, Kinjo Mitsuyo
Medicine, Okinawa Chubu Hospital, Uruma, Okinawa, Japan.
Cardiology, Okinawa Chubu Hospital, Uruma, Okinawa, Japan.
BMJ Case Rep. 2021 Mar 19;14(3):e240098. doi: 10.1136/bcr-2020-240098.
A postpartum patient with acute-onset dyspnoea and hypotention, associated with reduced left ventricular function requiring intensive blood pressure control, was initially misdiagnosed as having peripartum cardiomyopathy. Her clinical symptoms rapidly resolved. Echocardiography revealed reversible left ventricular dysfunction with apical ballooning and coronary angiography was normal. Based on these findings, we diagnosed takotsubo syndrome. Over the next two months, the patient experienced repeated bouts of elevated sympathetic activity. On workup, we found an adrenal mass and elevated urine metanephrines. After adrenalectomy, histology confirmed pheochromocytoma. Our patient had the rare diagnosis of postpartum pheochromocytoma-induced takotsubo syndrome.
一名产后患者出现急性呼吸困难和低血压,伴有左心室功能减退,需要强化血压控制,最初被误诊为围产期心肌病。她的临床症状迅速缓解。超声心动图显示左心室功能可逆性障碍伴心尖气球样变,冠状动脉造影正常。基于这些发现,我们诊断为应激性心肌病。在接下来的两个月里,患者反复出现交感神经活动亢进发作。经检查,我们发现一个肾上腺肿块和尿间甲肾上腺素升高。肾上腺切除术后,组织学检查证实为嗜铬细胞瘤。我们的患者罕见地诊断为产后嗜铬细胞瘤诱发的应激性心肌病。