Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2022; 10(29): 10772-10778
Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10772
Atypical Takotsubo cardiomyopathy presenting as acute coronary syndrome: A case report
Zi-Han Wang, Jia-Rong Fan, Gao-Yu Zhang, Xian-Lun Li, Lin Li
Zi-Han Wang, Jia-Rong Fan, Gao-Yu Zhang, Beijing University of Chinese Medicine, Graduate School, Beijing 100029, Chaoyang District, China
Xian-Lun Li, Lin Li, Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing 100029, Chaoyang District, China
Author contributions: Li L did the conception and design; Wang ZH collected the data and wrote the manuscript; Fan JR and Zhang GY performed the patient follow-up; Wang ZH and Fan JR analyzed and interpreted the data; Li XL made important revisions to the manuscript; all authors approved the final manuscript.
Supported by the Capital Health Development Scientific Research Project, No. 2018–2-4063; and Elite Medical Professionals Project of China-Japan Friendship Hospital, No. ZRJY2021-TD03.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Lin Li, PhD, Doctor, Professor, Department of Integrative Cardiology, China-Japan Friendship Hospital, No. 2 Yinghua East Street, Beijing 100029, Chaoyang District, China.
Received: June 23, 2022
Peer-review started: June 23, 2022
First decision: July 12, 2022
Revised: July 22, 2022
Accepted: August 30, 2022
Article in press: August 30, 2022
Published online: October 16, 2022

Takotsubo cardiomyopathy (TS) is a rare acute cardiac disease with clinical features, symptoms, and electrocardiographic manifestations similar to those of acute myocardial infarction. We present the case of a patient with TS caused by a pheochromocytoma, which was confirmed by the postoperative pathology. Furthermore, we present the patient's subsequent management, treatment, and outcome.


A 64-year-old woman was admitted to the hospital with episodic chest pain and palpitations, electrocardiogram (ECG) findings suggestive of high lateral wall myocardial infarction, echocardiogram showing left ventricular wall segmental motion abnormalities, and elevated levels of the myocardial marker troponin. The patient underwent coronary angiography, which revealed unobstructed blood flow without obvious stenosis. During their hospitalization, the patient had paroxysmal elevation of blood pressure accompanied by palpitations and profuse sweating, with elevated blood catecholamine levels during seizures. Subsequent computerized tomography of the adrenal glands revealed the presence of a nodule in the right adrenal, which was resected and determined to be an adrenal pheochromocytoma. Therefore, the diagnosis of pheochromocytoma-induced atypical TS was made. The patient had an uneventful postoperative recovery.


Cardiologists should consider pheochromocytoma in patients with TS. Early detection allows timely intervention, benefiting patients.

Keywords: Takotsubo cardiomyopathy, Acute coronary syndromes, Pheochromocytoma, Diagnose, Prognosis, Case report

Core Tip: Pheochromocytomas are a common class of endocrine tumors that can cause cardiovascular pathology, often resulting in stress cardiomyopathy due to the intermittent or sustained release of catecholamines. We report a patient with a postoperatively confirmed diagnosis of Takotsubo cardiomyopathy caused by pheochromocytoma.