The simultaneous occurrence of paraganglioma, Takotsubo syndrome, and Markis type I coronary artery ectasia in the same patient is a rare, high-risk clinical syndrome: a case report.
Case report
Coronary artery ectasia
Diagnostic imaging
Paraganglioma
Phenoxybenzamine
Takotsubo syndrome
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
03 11 2023
03 11 2023
Historique:
received:
02
04
2023
accepted:
25
10
2023
medline:
6
11
2023
pubmed:
4
11
2023
entrez:
4
11
2023
Statut:
epublish
Résumé
Population-wide, paraganglioma (PGL) is uncommon. The incidence of Takotsubo syndrome (TTS) ranges from 0.5% to 0.9% and also is an exceedingly rare manifestation of PGL. Coronary artery ectasia (CAE) is also uncommon, with an incidence ranging from 1.2% to 4.9%. Herein, we present a case of PGL, TTS, and Markis type I CAE that occured in the same patient. A man in his early 40s was admitted to our hospital with a 16-hour history of abdominal colic. Computed tomography and laboratory examination led to the diagnosis of PGL, coronary angiography led to the diagnosis of Markis type I or Chinese type III CAE, and two echocardiographic examinations led to the diagnosis of TTS. When the patient was treated by phenoxybenzamine instead of surgery for the PGL, his blood pressure and glucose level gradually returned to normal. The CAE was treated by thrombolysis, antiplatelet medications, atorvastatin, and myocardial protection therapies. No symptoms of PGL, CAE, or TTS were seen during a 6-month follow-up, and the patient had an excellent quality of life. We confirmed that phenoxybenzamine was the cause of the TTS because paradoxical systolic motion of the apex, inferior wall, left ventricular anterior wall, and interventricular septum were similarly recovered when the PGL was treated by phenoxybenzamine. To raise awareness of this illness and prevent misdiagnosis, we have herein presented a case of TTS that was brought on by PGL with Markis type I CAE for clinicians' reference. In addition, in clinical practice, we should consider the possibility of a concomitant coronary artery disease even if the TTS is caused by a PGL-induced catecholamine surge.
Sections du résumé
BACKGROUND
Population-wide, paraganglioma (PGL) is uncommon. The incidence of Takotsubo syndrome (TTS) ranges from 0.5% to 0.9% and also is an exceedingly rare manifestation of PGL. Coronary artery ectasia (CAE) is also uncommon, with an incidence ranging from 1.2% to 4.9%. Herein, we present a case of PGL, TTS, and Markis type I CAE that occured in the same patient.
CASE PRESENTATION
A man in his early 40s was admitted to our hospital with a 16-hour history of abdominal colic. Computed tomography and laboratory examination led to the diagnosis of PGL, coronary angiography led to the diagnosis of Markis type I or Chinese type III CAE, and two echocardiographic examinations led to the diagnosis of TTS. When the patient was treated by phenoxybenzamine instead of surgery for the PGL, his blood pressure and glucose level gradually returned to normal. The CAE was treated by thrombolysis, antiplatelet medications, atorvastatin, and myocardial protection therapies. No symptoms of PGL, CAE, or TTS were seen during a 6-month follow-up, and the patient had an excellent quality of life. We confirmed that phenoxybenzamine was the cause of the TTS because paradoxical systolic motion of the apex, inferior wall, left ventricular anterior wall, and interventricular septum were similarly recovered when the PGL was treated by phenoxybenzamine.
CONCLUSIONS
To raise awareness of this illness and prevent misdiagnosis, we have herein presented a case of TTS that was brought on by PGL with Markis type I CAE for clinicians' reference. In addition, in clinical practice, we should consider the possibility of a concomitant coronary artery disease even if the TTS is caused by a PGL-induced catecholamine surge.
Identifiants
pubmed: 37924047
doi: 10.1186/s12872-023-03577-1
pii: 10.1186/s12872-023-03577-1
pmc: PMC10625213
doi:
Substances chimiques
Phenoxybenzamine
0TTZ664R7Z
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
536Informations de copyright
© 2023. The Author(s).
Références
Am J Cardiol. 1976 Feb;37(2):217-22
pubmed: 1108631
Eur Heart J. 2018 Jun 7;39(22):2047-2062
pubmed: 29850820
Arch Pathol Lab Med. 2008 May;132(5):823-8
pubmed: 18466032
Zhonghua Xin Xue Guan Bing Za Zhi. 2018 Oct 24;46(10):756-759
pubmed: 30369167
N Engl J Med. 2005 Feb 10;352(6):539-48
pubmed: 15703419
Adv Exp Med Biol. 2018;1114:19-29
pubmed: 29884920
Int J Cardiol. 2017 Feb 1;228:528-536
pubmed: 27875730
Herz. 2020 May;45(3):252-266
pubmed: 32206851
Curr Cardiol Rev. 2016;12(4):318-323
pubmed: 27142049
Front Biosci (Elite Ed). 2012 Jan 01;4(1):300-10
pubmed: 22201872
Eur Heart J. 2018 Jun 7;39(22):2032-2046
pubmed: 29850871
Hypertens Res. 2004 Mar;27(3):193-202
pubmed: 15080378
Eur Cardiol. 2017 Aug;12(1):58-62
pubmed: 30416553
Circulation. 2012 Aug 7;126(6):697-706
pubmed: 22732314
Glob Cardiol Sci Pract. 2017 Oct 31;2017(3):e201726
pubmed: 29564347
Int J Cardiol. 2020 Jun 15;309:23-24
pubmed: 32192747
Heart. 2017 Sep;103(18):1461-1469
pubmed: 28839096
J Clin Endocrinol Metab. 2014 Jun;99(6):1915-42
pubmed: 24893135
Am Heart J. 2002 Mar;143(3):448-55
pubmed: 11868050
Interact Cardiovasc Thorac Surg. 2010 Jun;10(6):1047-8
pubmed: 20197349
Int Heart J. 2018 Mar 30;59(2):250-255
pubmed: 29503405
Minerva Cardioangiol. 2010 Feb;58(1):156-7
pubmed: 20150862