Clinical Research in Cardiology

, Volume 95, Issue 5, pp 307–311 | Cite as

Recurrent tako–tsubo–like left ventricular dysfunction (apical ballooning) in a patient with pheochromocytoma—a case report

  • Christoph Spes
  • Alexander Knape
  • Harald Mudra


Primarily described in Japan, tako–tsubo–like left ventricular dysfunction is a phenomenon characterized by transient apical ballooning in the absence of significant coronary artery disease. The clinical presentation includes symptoms like chest pain, dyspnea, syncope, electrocardiographic changes and elevated myocardial markers, all compatible with the diagnosis of an acute coronary syndrome. The underlying mechanism is supposed to be a catecholamine excess caused by various triggers. We describe a patient with a recurrent tako–tsubo phenomenon, who at work–up proved to have a pheochromocytoma as the most likely underlying disease.

Key words

Tako–tsubo–like left ventricular dysfunction pheochromocytoma 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Abe Y, Kondo M, Matsuoka R, Araki M, Dohyama K, Tanio H (2003) Assessment of clinical features in transient left ventricular apical ballooning. J Am Coll Cardiol 41:737–742CrossRefPubMedGoogle Scholar
  2. 2.
    De Backer TL, De Buyzere ML, Taeymans Y, Kunnen P, Rubens R, Clement DL (2000) Cardiac involvement in pheochromocytoma. J Hum Hypertens 14:469–471CrossRefPubMedGoogle Scholar
  3. 3.
    Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright, S, Rihaö CS (2004) Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST–segment elevation myocardial infarction. Ann Intern Med 141:858–865PubMedGoogle Scholar
  4. 4.
    Katechis D, Makaryus AN, Spatz A, Freeman J, Diamond JA (2005) Case report and brief review: acute myocardial infarction in a patient with pheochromocytoma and neurofibromatosis. J Invasive Cardiol 17:331–333PubMedGoogle Scholar
  5. 5.
    Liao WB, Liu CF, Chiang CW, Kung CT, Lee CW (2000) Cardiovascular manifestations of pheochromocytoma. Am J Emerg Med 18:622–625CrossRefPubMedGoogle Scholar
  6. 6.
    Schimke KE, Clerici T, Galeazzi RL, Pavlicek V (2004) Seltene Differentialdiagnose von EKG–Veränderungen und erhöhtem Troponin. Schweiz Med Forum 4:285–287Google Scholar
  7. 7.
    Shaw TR, Rafferty P, Tait GW (1987) Transient shock and myocardial impairment caused by phaeochromocytoma crisis. Br Heart J 57:194–198CrossRefPubMedGoogle Scholar
  8. 8.
    Tsuchihashi K, Ueshima K, Uchida T, Oh–mura N, Kimura K, Owa M, Yoshiyama M, Miyazaki S, Haze K, Ogawa H, Honda T, Hase M, Kai R, Morii I (2001) Transient left ventricular apical ballooning without coronary stenosis: a novel heart syndrome mimicking acute myocardial infarction. J Am Coll Cardiol 38:11–18CrossRefPubMedGoogle Scholar
  9. 9.
    Wittstein IS, Thiemann DR, Lima JAC, Baughman KL, Ahulman SP, Gerstenblith G, Wu KC, Rade JJ, Bivalaqua TJ, Champion HC (2005) Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med 352:539–548CrossRefPubMedGoogle Scholar

Copyright information

© Steinkopff-Verlag 2006

Authors and Affiliations

  • Christoph Spes
    • 1
  • Alexander Knape
    • 1
  • Harald Mudra
    • 1
  1. 1.2. Medizinische AbteilungKlinikum Neuperlach, Städtisches Klinikum München GmbHMünchenGermany

Personalised recommendations