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Letters to the Editor|Articles in Press

Pheochromocytoma-Induced Myocardial Dysfunction: Further Implications

      In the clinical setting, pheochromocytoma-induced Takotsubo syndrome (TTS) is a relatively rare and life-threatening condition (
      • Artusi N
      • Bussani R
      • Cominotto F
      Pheochromocytoma-induced Takotsubo syndrome: an uncommon presentation.
      ,
      • Yalta K
      • Yalta T
      • Yetkin E
      Pheochromocytoma and takotsubo syndrome: an ominous duo.
      ,
      • Yalta K
      • Ozkan U
      • Yalta T
      • et al.
      Takotsubo syndrome in association with pheochromocytoma: clinical and practical considerations.
      ). Clinically, this phenomenon might present with atypical patterns (including inverted TTS) along with signs of severe adrenergic discharge, such as malignant arrhythmias and coronary slow flow pattern on coronary angiogram (CAG) (
      • Yalta K
      • Yalta T
      • Yetkin E
      Pheochromocytoma and takotsubo syndrome: an ominous duo.
      ,
      • Yalta K
      • Ozkan U
      • Yalta T
      • et al.
      Takotsubo syndrome in association with pheochromocytoma: clinical and practical considerations.
      ). The recent article by Artusi et al. described two cases with a pheochromocytoma-induced TTS (
      • Artusi N
      • Bussani R
      • Cominotto F
      Pheochromocytoma-induced Takotsubo syndrome: an uncommon presentation.
      ). In this context, we would like to underscore atypical patterns of myocardial dysfunction (and their implications), including catecholamine-induced myocarditis (also known as chemical myocarditis) and rare TTS variants in the setting of pheochromocytoma (
      • Yalta K
      • Yalta T
      • Yetkin E
      Pheochromocytoma and takotsubo syndrome: an ominous duo.
      ,
      • Yalta K
      • Ozkan U
      • Yalta T
      • et al.
      Takotsubo syndrome in association with pheochromocytoma: clinical and practical considerations.
      ,
      • de Miguel V
      • Arias A
      • Paissan A
      • et al.
      Catecholamine-induced myocarditis in pheochromocytoma.
      ).
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      References

        • Artusi N
        • Bussani R
        • Cominotto F
        Pheochromocytoma-induced Takotsubo syndrome: an uncommon presentation.
        J Emerg Med. 2022; 64 (00–00)
        • Yalta K
        • Yalta T
        • Yetkin E
        Pheochromocytoma and takotsubo syndrome: an ominous duo.
        Anatol J Cardiol. 2022; 26: 668-669
        • Yalta K
        • Ozkan U
        • Yalta T
        • et al.
        Takotsubo syndrome in association with pheochromocytoma: clinical and practical considerations.
        Monaldi Arch Chest Dis. 2021; 91
        • de Miguel V
        • Arias A
        • Paissan A
        • et al.
        Catecholamine-induced myocarditis in pheochromocytoma.
        Circulation. 2014; 129: 1348-1349