A case of pheochromocytoma presenting as syncope due to long QT syndrome

Authors

  • Mohammad Hayat Bhat Department of Endocrinology, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Henna Naqash Department of Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Parvaiz Ahmad Zargar Department of Cardiology, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Sajad Ahmad Sumji Department of Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Parvaiz Ahmad Shah Department of Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20181092

Keywords:

Arrhythmia, Catecholamines, Syncope, Tumour

Abstract

Pheochromocytoma, a catecholamine secreting tumour, is rare and we are presenting such a case who presened with syncopal episodes due to arrhythmias associated with the tumour. The patient was managed with pharmacologic and surgical treatment.

References

Lloyd RV, Tischer AS, Kimura N, et al. Adrenal tumors: introduction. In: DeLellis RA, Lloyd RV, Heitz PU, et al. eds. World Health Organization classification of tumours: pathology and genetics of tumours of endocrine organs. 4thed. Lyon, France: IARC Press; 2004:136-8.

Stenström G, Svårdsudd K. Pheochromocytoma in Sweden 1958-1981. J Intern Med. 1986;220(3):225-32.

Young Jr WF. Pheochromocytoma: 1926-1993. Trends Endocrinol Metab. 1993;4(4):122-7.

Munakata M, Aihara A, Imai Y, Noshiro T, Ito S, Yoshinaga K. Altered sympathetic and vagal modulations of the cardiovascular system in patients with pheochromocytoma: their relations to orthostatic hypotension. Am J Hypertens. 1999;12(6):572-80.

Dubois LA, Gray DK. Dopamine-secreting pheochromocytomas: in search of a syndrome. World J Surg. 2005;29(7):909-13.

Eisenhofer G, Goldstein DS, Sullivan P, Csako G, Brouwers FM, Lai EW et al. Biochemical and clinical manifestations of dopamine-producing paragangliomas: utility of plasma methoxytyramine. J Clin Endocrinol. 2005;90(4):2068-75.

Leite LR, Macedo PG, Santos SN, Quaglia L, Mesas CE, De Paola A. Life-threatening cardiac manifestations of pheochromocytoma. Case reports Medicine. 2010;2010.

Liao WB, Liu CF, Chiang CW, Kung CT, Lee CW. Cardiovascular manifestations of pheochromocytoma. Am J Emerg Med. 2000;18(5):622-5.

Stenström G, Swedberg K. Qrs amplitudes, QTc intervals and ECG abnormalities in pheochromocytoma patients before, during and after treatment. J Internal Med. 1988;224(3):231-5.

Madias C, Fitzgibbons TP, Alsheikh-Ali AA, Bouchard JL, Kalsmith B, Garlitski AC, et al. Acquired long QT syndrome from stress cardiomyopathy is associated with ventricular arrhythmias and torsades de pointes. Heart Rhythm. 2011;8(4):555-61.

Eisenhofer G, Rivers G, Rosas AL, Quezado Z, Manger WM, Pacak K. Adverse drug reactions in patients with phaeochromocytoma. Drug Saf. 2007 Nov;30(11):1031-62.

Bybee KA, Prasad A. Stress-related cardiomyopathy syndromes. Circulation. 2008;118(4):397-409.

Kihara H, Terai H, Kihara Y, Kihara T, Takahashi H, Kosuda A et al. Pheochromocytoma of the left retroperitoneal paraganglion associated with torsade de pointes: a case report. Am J Cardiol. 1997;30(1):37-44.

Shimizu K, Miura Y, Meguro Y, et al: QT prolongation with torsade de pointes in pheochromocytoma. Am Heart J. 1992;124:235-9.

Sani IM, Solomon DS, Imhogene OA, Ahmad AM, Bala GS: QT dispersion in adult hypertensives. J Natl Med Assoc. 2006;98:631-6.

Roshan J, George OK, Vineet S, George PV, Jose VJ. Torsade de pointes in a case of pheochromocytoma: an unusual presentation of an uncommon disease. Indian Heart J. 2004;56:248-9.

Stenström G, Swedberg K. QRS amplitudes, QTc intervals and ECG abnormalities in pheochromocytoma patients before, during and after treatment. Acta Med Scand. 1988;224:231-5.

Gifford Jr RW, Bravo EL, Manger W. Diagnosis and management of pheochromocytoma. Cardiology. 1985;72:126-30.

John Roshan, Oommen K George et al., Torsade de Pointes in a case of pheochromocytoma: an unusual presentation of an uncommon disease. Indian Heart J. 2004;56:248-9.

Michaels RD, Hays JH, O’Brian JT, Shakir KM. Pheochromocytoma associated ventricular tachycardia blocked with atenolol. J Endocrinol Invest. 1990 Dec;13(11):943-7.

Dabrowska B, Pruszczyk P, Dabrowski A, Feltynowski T, Wocial B, Januszewicz W. Influence of alpha-adrenergic blockade on ventricular arrhythmias, QTc interval and heart rate variability in phaeochromocytoma. J Hum Hypertens. 1995;9(11):925-9.

Chakraborty P, Bhattacharjeee HK, Anandaraja S. Palpitition, presyncope and abdominal mass. Indian Heart Journal. 2010;62(5):447-8

Paulin FL, Klein GJ, Gula LJ, Skanes AC, Yee R, Krahn AD.QT prolongation and monomorphic VT caused by pheochromocytoma. J Cardiovasc Electrophysiol. 2009;20(8):931-4.

Sacha J, Wester A, Hordynski G, Pluta W. QT interval prolongation during ECG evolution in takotsubo cardiomyopathy poses a threat of torsade de pointes to predisposed patients: case report of a female patient with congenital AV block. Herz. 2013;38:790-5.

vander Heide K, de Haes A, Wietasch GJ, Wiesfeld AC, Hendriks HG. Torsades de pointes during laparoscopic adrenalectomy of a pheochromocytoma: a case report. J Med Case Rep. 2011;5:368.

Chakraborty P, Bhattacharjeee HK, Anandaraja S. Palpitition, presyncope and abdominal mass. Indian Heart J. 2010;62:447-8.

Goldbaum TS, Henochowicz S, Mustafa M, Blunda M, Lindsay J., Jr Pheochromocytoma presenting with Prinzmetal's angina. Am J Med. 1986;81:921-2.

Cheng TO, Bashour TT. Striking electrocardiographic changes associated with pheochromocytoma. Masquerading as ischemic heart disease. Chest. 1976;70:397-9.

Schurmeyer TH, Engeroff B, Dralle H. Cardiological effects of catecholamine-secreting tumours. Eur J Clin Invest. 1997;27:189-95.

Liao WB, Liu CF, Chiang CW, Kung CT, Lee CW. Cardiovascular manifestations of pheochromocytoma. Am J Emerg Med. 2000;18(5):622-5.

Viskin S, Fish R, Roth A, Schwartz PJ, Belhassen B. Clinical problem solving. QT or not QT. N Engl J Med. 2000;343:352-6.

Stenstrom G, Swedberg K. QRS amplitudes, QTc intervals and ECG abnormalities in pheochromocytoma patients before, during and after treatment. Acta Med Scand. 1988;224:231-5.

Methe H, Hinterseer M, Wilbert-Lampen U, Beckmann BM, Steinbeck G, Kääb S. Torsades de Pointes: a rare complication of an extra-adrenal pheochromocytoma. Hypertens Res. 2007;30(12):1263.

Downloads

Published

2018-03-21

Issue

Section

Case Reports