Cardiogenic Shock Due to Inverted-Pattern Takotsubo Syndrome Caused by Pheochromocytoma: Case Report and Literature Review

Introduction

Takotsubo syndrome (TTS) is characterized by an acute impairment of myocardial contractility caused by sympathetic hyperstimulation after emotional or physical stress.^, Apical ballooning is the typical and most common pattern, a feature that gave rise to the classic term described by Sato et al. in 1990, due to its similarity to the historical Japanese octopus trap. Atypical patterns include mid-basal, basal, and focal wall motion abnormalities.

Data from multicenter registries reveal that 1 to 3% of patients suspected of having an acute myocardial infarction (AMI) are alternatively diagnosed with TTS,^, and in-hospital mortality rates are comparable to those of patients with AMI and range from 3.2 to 10.6%,^– mainly caused by cardiogenic shock or sudden death from ventricular arrhythmias. In contrast to other cardiomyopathies, the ventricular contractility deficit in TTS is transient, and complete recovery usually occurs within days to weeks.

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