Tako-tsubo cardiomyopathy precipitated by pheochromocytoma crisis

Abstract

We report the case of a 69 year-old Chinese lady with pheochromocytoma who developed chest pain and acute ST-segment elevation in the anterior leads on electrocardiography. She was given intravenous phenoxybenzamine for alpha-blockade before undergoing urgent coronary angiography. This revealed minor coronary artery disease. Left ventriculogram demonstrated akinesis in the apex with hypercontraction of the basal segments. The Tako-tsubo cardiomyopathy eventually resolved with surgical removal of the pheochromocytoma. This case highlights the challenging management of suspected acute myocardial infarction in pheochromocytoma crisis and also reinforces the notion that Tako-tsubo cardiomyopathy is likely precipitated by catecholamine excess.