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  2. Keyword: Pheochromocytoma
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Research Letter

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

Pedro Ivo De Marqui Moraes et al. Michell Fayad André Haddad Daniel Bisi de Bôrtoli Valle Luiz Otávio de Oliveira Filho … Mayara da Silva Custódio Dirceu Rodrigues de Almeida

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.

[…]

  • Cardiogenic shock
  • Pheochromocytoma
  • Takotsubo Cardiomyopathy
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Creative Commons Attribution (CC BY) Creative Commons license
23/03/2026 DOI: 10.36660/abc.20250558i Views 3
Another Cause of Acute Cardiogenic Shock
ABC
Anatomopathological Correlation

Another Cause of Acute Cardiogenic Shock

Gonçalo Morgado et al. Filipe Gonzalez Ana Alves Oliveira Antero Fernandes

Clinical Case

A 64-year-old woman with a history of Diabetes and Hypertension was admitted to the emergency department with acute dyspnea and chest pain. Physical examination revealed hypertension, sinus tachycardia (150 bpm), acute pulmonary edema and poor extremity perfusion. In the context of respiratory failure and hemodynamic instability, she required invasive mechanical ventilation. Blood works showed increased levels of hs-TroponinT (rising from 800 to 1600 ng/L) and the ECG showed poor R wave progression and incomplete right bundle branch block. The echocardiogram revealed a hypertrophied left ventricle, with severe systolic dysfunction and akinetic apical and middle segments. Considering the possibility of acute coronary syndrome, the patient was referred for emergent coronary angiography, which revealed normal coronary arteries. She was admitted to the intensive care unit with the presumed diagnosis of Takotsubo cardiomyopathy. Through the rest of the day, she presented with fluctuating blood pressure and required elevated levels of positive end-expiratory pressure due to pulmonary edema. Despite an apparent favorable evolution, she suddenly developed asystole, refractory to resuscitation efforts, dying less than 24 hours after admission.

[…]

  • Heart Failure
  • Pheochromocytoma
  • Respiratory Insufficiency
  • Shock, Cardiogenic
  • Takotsubo Cardiomyopathy/complications
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Creative Commons Attribution (CC BY) Creative Commons license
02/12/2019 DOI: 10.36660/abc.9453 Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Moraes PIDM, Haddad MFA, Valle DBB, Oliveira Filho LO, Custódio MS, Almeida DR. Cardiogenic Shock Due to Inverted-Pattern Takotsubo Syndrome Caused by Pheochromocytoma: Case Report and Literature Review. Arquivos Brasileiros de Cardiologia 2026;123(2):e20250558.

Electronic Document Format (ABNT)

Moraes, Pedro Ivo De Marqui; Haddad, Michell Fayad André; Valle, Daniel Bisi de Bôrtoli; Oliveira Filho, Luiz Otávio de; Custódio, Mayara da Silva; Almeida, Dirceu Rodrigues de. Cardiogenic Shock Due to Inverted-Pattern Takotsubo Syndrome Caused by Pheochromocytoma: Case Report and Literature Review. Arquivos Brasileiros de Cardiologia, v. 123, n. 2, e20250558, Mar. 2026.

Electronic Document Format (APA)

Moraes, P. I. D. M., Haddad, M. F. A., Valle, D. B. B., Oliveira Filho, L. O. , Custódio, M. S., & Almeida, D. R. (2026). Cardiogenic Shock Due to Inverted-Pattern Takotsubo Syndrome Caused by Pheochromocytoma: Case Report and Literature Review. Arquivos Brasileiros de Cardiologia, 123(2), e20250558.

Electronic Document Format (ISO)

Moraes, Pedro Ivo De Marqui and Haddad, Michell Fayad André and Valle, Daniel Bisi de Bôrtoli and Oliveira Filho, Luiz Otávio de and Custódio, Mayara da Silva and Almeida, Dirceu Rodrigues de. Cardiogenic Shock Due to Inverted-Pattern Takotsubo Syndrome Caused by Pheochromocytoma: Case Report and Literature Review. Arquivos Brasileiros de Cardiologia [online]. 2026, vol. 123, n. 2, [cited 2026-10-14], e20250558. Available from: <https://journals.cardiol.br/en/article/cardiogenic-shock-due-to-inverted-pattern-takotsubo-syndrome-caused-by-pheochromocytoma-case-report-and-literature-review/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Morgado G, Gonzalez F, Oliveira AA, Fernandes A. Another Cause of Acute Cardiogenic Shock. Arquivos Brasileiros de Cardiologia 2019;113(6):1150.

Electronic Document Format (ABNT)

Morgado, Gonçalo; Gonzalez, Filipe; Oliveira, Ana Alves; Fernandes, Antero. Another Cause of Acute Cardiogenic Shock. Arquivos Brasileiros de Cardiologia, v. 113, n. 6, p. 1150-1150, Dec. 2019.

Electronic Document Format (APA)

Morgado, G., Gonzalez, F., Oliveira, A. A., & Fernandes, A. (2019). Another Cause of Acute Cardiogenic Shock. Arquivos Brasileiros de Cardiologia, 113(6), 1150-1150.

Electronic Document Format (ISO)

Morgado, Gonçalo and Gonzalez, Filipe and Oliveira, Ana Alves and Fernandes, Antero. Another Cause of Acute Cardiogenic Shock. Arquivos Brasileiros de Cardiologia [online]. 2019, vol. 113, n. 6, [cited 2026-10-14], pp. 1150-1150. Available from: <https://journals.cardiol.br/en/article/another-cause-of-acute-cardiogenic-shock/>. ISSN 0066-782X

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