{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T18:29:06Z","timestamp":1779906546097,"version":"3.53.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T00:00:00Z","timestamp":1590364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Takotsubo-like cardiomyopathy associated with pheochromocytoma (Pheo-TTS) is a recognized but uncommon disorder. While Pheo-TTS might more often recur and the pattern of left ventricular (LV) wall motion abnormality is more diverse compared with primary TTS, it remains to be elucidated whether coronary functional abnormalities are also involved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case summary<\/jats:title><jats:p>A 50-year-old woman was referred with a chief complaint of transient chest pain, dyspnoea, and paroxysmal thyroid swelling that usually developed after meals. In the past, she had been admitted to emergency rooms three times due to pulmonary oedema following the above attacks. Serial cardiac catheterizations showed normal coronary arteries and morphologically different types of LV dysfunction each time; apical LV ballooning at the first, basal LV ballooning at the second, and diffuse LV hypokinesis at the last admission. Acetylcholine (ACh) provocation testing for coronary vasospasm was negative at the second admission. During hospitalization in our department, abdominal ultrasonography for screening detected a right adrenal mass and the urinary normetanephrine level was increased. The adrenal tumour was urgently removed surgically and finally she was diagnosed as having norepinephrine-secreting pheochromocytoma. Acetylcholine testing was again performed just after the operation, showing both epicardial and microvascular coronary spasms. Since the operation, she has been free of symptoms. Importantly, ACh testing at 1-year follow-up showed that epicardial spasm was no longer noted, whereas coronary microvascular spasm persisted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Adrenal pheochromocytoma could cause recurrent attacks of catecholamine surges with different patterns of LV dysfunction, where coronary vasospasm may also be involved along the coronary arteries.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa138","type":"journal-article","created":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T12:49:59Z","timestamp":1590410999000},"page":"1-5","source":"Crossref","is-referenced-by-count":7,"title":["A case of recurrent takotsubo-like cardiomyopathy associated with pheochromocytoma exhibiting different patterns of left ventricular wall motion abnormality and coronary vasospasm: a case report"],"prefix":"10.1093","volume":"4","author":[{"given":"Koichi","family":"Sato","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3497-8571","authenticated-orcid":false,"given":"Keiko","family":"Amano","sequence":"additional","affiliation":[{"name":"Seifuusou Hospital, 1-9-28 Horinouchi, Niiza 352-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7255-3366","authenticated-orcid":false,"given":"Hiroaki","family":"Shimokawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,25]]},"reference":[{"key":"2020101507145118800_ytaa138-B1","doi-asserted-by":"crossref","first-page":"2426","DOI":"10.1161\/CIRCULATIONAHA.116.027121","article-title":"Pathophysiology of takotsubo syndrome","volume":"135","author":"Pelliccia","year":"2017","journal-title":"Circulation"},{"key":"2020101507145118800_ytaa138-B2","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1210\/jc.2014-1498","article-title":"Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline","volume":"99","author":"Lenders","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"2020101507145118800_ytaa138-B3","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.ijcard.2011.03.027","article-title":"Takotsubo-like cardiomyopathy in pheochromocytoma","volume":"153","author":"Agarwal","year":"2011","journal-title":"Int J Cardiol"},{"key":"2020101507145118800_ytaa138-B4","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.1016\/j.amjcard.2016.03.019","article-title":"Clinical features and outcome of pheochromocytoma-induced takotsubo syndrome: analysis of 80 published cases","volume":"117","author":"Y-Hassan","year":"2016","journal-title":"Am J Cardiol"},{"key":"2020101507145118800_ytaa138-B5","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1067\/mhj.2002.120403","article-title":"Tako-tsubo-like left ventricular dysfunction with ST-segment elevation: A novel cardiac syndrome mimicking acute myocardial infarction","volume":"143","author":"Kurisu","year":"2002","journal-title":"Am Heart J"},{"key":"2020101507145118800_ytaa138-B6","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ijcard.2017.07.032","article-title":"Abnormal coronary vasoreactivity in transient left ventricular apical ballooning (tako-tsubo) syndrome","volume":"250","author":"Verna","year":"2018","journal-title":"Int J Cardiol"},{"key":"2020101507145118800_ytaa138-B7","first-page":"489","article-title":"Plasma concentration of serotonin is a novel biomarker for coronary microvascular dysfunction in patients with suspected angina and unobstructive coronary arteries","volume":"38","author":"Odaka","year":"2016","journal-title":"Eur Heart J"},{"key":"2020101507145118800_ytaa138-B8","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/S0140-6736(05)67139-5","article-title":"Phaeochromocytoma","volume":"366","author":"Lenders","year":"2005","journal-title":"Lancet"},{"key":"2020101507145118800_ytaa138-B9","first-page":"371","article-title":"Paroxysmal hypertension and other clinical manifestation associated with benign chromaffin cell tumor (phaeochromocytoma)","volume":"61","author":"Howard","year":"1937","journal-title":"Bull Johns Hopkins Hosp"},{"key":"2020101507145118800_ytaa138-B10","doi-asserted-by":"crossref","first-page":"3601","DOI":"10.1210\/jc.2011-1718","article-title":"Paroxysmal thyroid swelling. A forgotten clinical finding of pheochromocytoma","volume":"96","author":"Nakamura","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"2020101507145118800_ytaa138-B11","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1056\/NEJMoa1406761","article-title":"Clinical features and outcomes of takotsubo (stress) cardiomyopathy","volume":"373","author":"Templin","year":"2015","journal-title":"N Engl J Med"},{"key":"2020101507145118800_ytaa138-B12","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1210\/endo-113-1-354","article-title":"Selective down-regulation of adrenergic receptor subtypes in tissues from rats with pheochromocytoma","volume":"113","author":"Snavely","year":"1983","journal-title":"Endocrinology"},{"key":"2020101507145118800_ytaa138-B13","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1161\/CIRCULATIONAHA.112.111591","article-title":"High levels of circulating epinephrine trigger apical cardiodepression in a \u03b22-adrenergic receptor\/Gi-dependent manner: a new model of takotsubo cardiomyopathy","volume":"126","author":"Paur","year":"2012","journal-title":"Circulation"},{"key":"2020101507145118800_ytaa138-B14","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1056\/NEJM199111283252205","article-title":"The effect of atherosclerosis on the vasomotor response of coronary arteries to mental stress","volume":"325","author":"Yeung","year":"1991","journal-title":"N Engl J Med"},{"key":"2020101507145118800_ytaa138-B15","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1177\/2048872613475891","article-title":"Impaired coronary microvascular reactivity in women with apical ballooning syndrome (takotsubo\/stress cardiomyopathy)","volume":"2","author":"Patel","year":"2013","journal-title":"Eur Heart J Acute Cardiovasc Care"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/4\/1\/33889707\/ytaa138.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/4\/1\/33889707\/ytaa138.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T12:36:31Z","timestamp":1696163791000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/4\/4\/1\/5843747"}},"subtitle":[],"editor":[{"given":"Domenico","family":"D'Amario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Luca","family":"Arcari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Luca","family":"Moderato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Ivan","family":"Illic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Max","family":"Sayers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Vassilios Parisis","family":"Memtsas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,5,25]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,5,25]]},"published-print":{"date-parts":[[2020,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaa138","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,8]]},"published":{"date-parts":[[2020,5,25]]}}}