Catecholamine-induced Cardiomyopathy Secondary to Pheochromocytoma Mimicking Fulminant Acute Myocarditis

• Published in: Acta Cardiologica Sinica Vol. 23; no. 2; pp. 125 - 130
• Main Authors: 楊永年(Yung-Nien Yang), 莊義成(Yi-Cheng Chuang), 殷偉賢(Wei-Hsian Yin), 楊茂勳(Mason Shing Young)
• Format: Journal Article
• Language: English
• Published: 台灣 中華民國心臟學會 01.06.2007
• Subjects: Acute myocarditis; Acute pulmonary edema; Catecholamine-induced cardiomyopathy; MEDLINE; Pheochromocytoma; SCI; Scopus; 兒茶酚心肌病變; 嗜鉻性細胞瘤; 急性心肌炎; 急性肺水腫; 急性肺水腫; 嗜鉻性細胞瘤; Pheochromocytoma; Acute pulmonary edema; 急性心肌炎; Acute myocarditis; Catecholamine-induced cardiomyopathy; 兒茶酚心肌病變
• ISSN: 1011-6842

嗜鉻性細胞瘤是一種少見之分泌兒茶酚的腫瘤（約佔所有高血壓患者的百分之0.1至百分之0.8），它可以表現出許多不同臨床及生化之表徵，但以急性心肌炎為表現非常罕見。一位46歲女性，經上呼吸道感染後表現出心因性休克及急性肺水腫，起初讓我們誤認為單純之急性病毒心肌炎。雖經動脈內氣球幫浦及葉克膜機器輔助逐漸改善心臟功能，但在機械性輔助器移除兩天後，患者之心臟功能又急速惡化。其陣髮性之高血壓、心跳過速、及短時間內急劇之心臟功能變化讓我們考慮到並進一步診斷其為嗜鉻性細胞瘤所致
Pheochromocytoma is a relatively rare catecholamine-secreting tumor (0.1 to 0.8% of hypertensives). It has a large spectrum of clinical and biochemical manifestations. The clinical manifestation of acute myocarditis has only rarely been reported. We describe a case of a 46-year-old woman who presented with cardiogenic shock associated with acute pulmonary edema following an upper respiratory infection, which was initially presumed to be acute viral myocarditis. Cardiac function progressively improved after serial management including intra-aortic balloon pump and extracorporeal membrane oxygenation but soon deteriorated two days after weaning off the mechanical support. The episodic high blood pressure, tachycardia and marked fluctuation of cardiac function during hospitalization subsequently led to the correct diagnosis of pheochromocytoma.