DOI: http://dx.doi.org/10.18203/2349-3933.ijam20181092

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

Mohammad Hayat Bhat, Henna Naqash, Parvaiz Ahmad Zargar, Sajad Ahmad Sumji, Parvaiz Ahmad Shah

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.


Keywords


Arrhythmia, Catecholamines, Syncope, Tumour

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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.