Limits...
Life-threatening cardiac manifestations of pheochromocytoma.

Leite LR, Macedo PG, Santos SN, Quaglia L, Mesas CE, De Paola A - Case Rep Med (2010)

Bottom Line: However, a wide range of signs and symptoms may be present.In the cardiovascular system, the most common signs are labile hypertension and sinus tachycardia.Systolic heart failure and ST-segment deviations mimicking myocardial infarction have also been reported, as well as QT interval prolongation and, rarely, ventricular tachycardia.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Cardiac Electrophysiology, Centro de Estudos em Arritmia Cardíaca, SMDB Conj. 16 Lote 5 Cs A, Brasilia-DF 71680-160, Brazil.

ABSTRACT
Pheochromocytoma is a catecholamine-secreting tumor of the adrenal glands, usually with benign manifestations, whose typical clinical presentation includes the triad of headache, palpitations and diaphoresis. However, a wide range of signs and symptoms may be present. In the cardiovascular system, the most common signs are labile hypertension and sinus tachycardia. Systolic heart failure and ST-segment deviations mimicking myocardial infarction have also been reported, as well as QT interval prolongation and, rarely, ventricular tachycardia. We describe a challenging diagnosis of pheochromocytoma with many cardiovascular manifestations, which could have been missed due to the absence of typical symptoms.

No MeSH data available.


Related in: MedlinePlus

Ventricular tachycardia with left bundle branch block morphology and left axis deviation.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2821753&req=5

fig1: Ventricular tachycardia with left bundle branch block morphology and left axis deviation.

Mentions: A 62-year-old female patient was admitted to our hospital to perform radical hysterectomy, which was complicated by postoperative incision infection. She had a history of systemic arterial hypertension, diabetes, and obesity. At the 20th day of admission, she complained of acute typical chest pain, followed by ST-segment elevation in anterolateral leads and increased CK and CK-MB serum levels, with a rise and fall typical curve [maximum of 856 mg/dL (reference range <240 mg/dL) and 154 mg/dL (reference range <24 mg/dL), resp.], and diagnosis of MI was made. She was treated with chemical thrombolysis, heparin, metoprolol, antiplatelet, and ACE inhibitor; primary angioplasty was not attempted. Twelve days after MI, she presented with palpitations and was again admitted to the ICU. She had no other symptoms, her heart rate (HR) was 160 bpm, blood pressure (BP) of 180/110 mmHg, and lung fields were clear. The ECG revealed a monomorphic VT with left bundle branch block morphology and left axis deviation (Figure 1). Ventricular tachycardia (VT) was reversed by intravenous amiodarone, and maintenance dose was initiated. In order to rule out an ischemic-related arrhythmia, a coronary angiogram was performed, showing only a 30% obstruction at the first marginal branch of the left circumflex coronary artery, and a discrete increase in the left ventricular diastolic volume. The chest X-ray was normal and the echocardiogram revealed hypokinesis of the lateral wall of the left ventricle, with a slightly decreased ejection fraction (LVEF = 56%).


Life-threatening cardiac manifestations of pheochromocytoma.

Leite LR, Macedo PG, Santos SN, Quaglia L, Mesas CE, De Paola A - Case Rep Med (2010)

Ventricular tachycardia with left bundle branch block morphology and left axis deviation.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2821753&req=5

fig1: Ventricular tachycardia with left bundle branch block morphology and left axis deviation.
Mentions: A 62-year-old female patient was admitted to our hospital to perform radical hysterectomy, which was complicated by postoperative incision infection. She had a history of systemic arterial hypertension, diabetes, and obesity. At the 20th day of admission, she complained of acute typical chest pain, followed by ST-segment elevation in anterolateral leads and increased CK and CK-MB serum levels, with a rise and fall typical curve [maximum of 856 mg/dL (reference range <240 mg/dL) and 154 mg/dL (reference range <24 mg/dL), resp.], and diagnosis of MI was made. She was treated with chemical thrombolysis, heparin, metoprolol, antiplatelet, and ACE inhibitor; primary angioplasty was not attempted. Twelve days after MI, she presented with palpitations and was again admitted to the ICU. She had no other symptoms, her heart rate (HR) was 160 bpm, blood pressure (BP) of 180/110 mmHg, and lung fields were clear. The ECG revealed a monomorphic VT with left bundle branch block morphology and left axis deviation (Figure 1). Ventricular tachycardia (VT) was reversed by intravenous amiodarone, and maintenance dose was initiated. In order to rule out an ischemic-related arrhythmia, a coronary angiogram was performed, showing only a 30% obstruction at the first marginal branch of the left circumflex coronary artery, and a discrete increase in the left ventricular diastolic volume. The chest X-ray was normal and the echocardiogram revealed hypokinesis of the lateral wall of the left ventricle, with a slightly decreased ejection fraction (LVEF = 56%).

Bottom Line: However, a wide range of signs and symptoms may be present.In the cardiovascular system, the most common signs are labile hypertension and sinus tachycardia.Systolic heart failure and ST-segment deviations mimicking myocardial infarction have also been reported, as well as QT interval prolongation and, rarely, ventricular tachycardia.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Cardiac Electrophysiology, Centro de Estudos em Arritmia Cardíaca, SMDB Conj. 16 Lote 5 Cs A, Brasilia-DF 71680-160, Brazil.

ABSTRACT
Pheochromocytoma is a catecholamine-secreting tumor of the adrenal glands, usually with benign manifestations, whose typical clinical presentation includes the triad of headache, palpitations and diaphoresis. However, a wide range of signs and symptoms may be present. In the cardiovascular system, the most common signs are labile hypertension and sinus tachycardia. Systolic heart failure and ST-segment deviations mimicking myocardial infarction have also been reported, as well as QT interval prolongation and, rarely, ventricular tachycardia. We describe a challenging diagnosis of pheochromocytoma with many cardiovascular manifestations, which could have been missed due to the absence of typical symptoms.

No MeSH data available.


Related in: MedlinePlus