A Delayed Diagnosis of Pheochromocytoma Revealed by Tako-Tsubo Cardiomyopathy

Abstract

Introduction: Pheochromocytoma is a rare cause of secondary arterial hypertension whose clinical presentation can be multifaceted. In particular, it may be revealed or complicated by cardiovascular manifestations independent of hypertension. These include Tako-Tsubo cardiomyopathy, an acute reversible dyskinetic cardiomyopathy associated with ballooning of the left ventricular apex. Observation: We present the case of a 32-year-old woman, diabetic for 2 years. Her history included untreated labile hypertension and emotional stress. She was admitted to a cardiac intensive care unit for left heart failure. Paraclinical investigations confirmed the diagnosis of Tako-Tsubo cardiomyopathy induced by pheochromocytoma. After a few days of medical treatment in the ICU, the outcome was favorable, with well-compensated heart failure, stable hemodynamics and restoration of left ventricular function. Conclusion: This observation raises the issue of delayed diagnosis of a pheochromocytoma revealed by a TTC. Despite its spectacular initial presentation, the evolution of the latter was rather favorable under appropriate treatment.