PDF(Pubmed)
Abstract：
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.
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.
摘要：
背景：全人群，副神经节瘤（PGL）并不常见。Takotsubo综合征（TTS）的发生率为0.5％至0.9％，也是PGL的极为罕见的表现。冠状动脉扩张症（CAE）也不常见，发病率从1.2%到4.9%不等。在这里，我们提出了一个PGL的案例，TTS,和MarkisI型CAE发生在同一患者中。
方法：一名40岁出头的男子入院，有16小时的腹绞痛病史。计算机断层扫描和实验室检查导致PGL的诊断，冠状动脉造影导致MarkisI型或中国III型CAE的诊断，和两次超声心动图检查导致TTS的诊断。当患者接受苯氧基苄胺而不是PGL手术治疗时，他的血压和血糖水平逐渐恢复正常。CAE采用溶栓治疗,抗血小板药物,阿托伐他汀,和心肌保护疗法。没有PGL的症状,CAE,或TTS在6个月的随访中出现，病人的生活质量很好。我们证实苯氧基苯甲胺是TTS的原因，因为心尖的反常收缩运动，下墙，左心室前壁,当PGL用苯氧苄胺治疗时，室间隔也同样恢复。
结论：为了提高对这种疾病的认识并防止误诊，我们在此介绍了一个由PGL和MarkisI型CAE带来的TTS病例，供临床医生参考。此外,在临床实践中，即使TTS是由PGL诱导的儿茶酚胺激增引起的,我们也应该考虑伴随冠状动脉疾病的可能性.
方法：一名40岁出头的男子入院，有16小时的腹绞痛病史。计算机断层扫描和实验室检查导致PGL的诊断，冠状动脉造影导致MarkisI型或中国III型CAE的诊断，和两次超声心动图检查导致TTS的诊断。当患者接受苯氧基苄胺而不是PGL手术治疗时，他的血压和血糖水平逐渐恢复正常。CAE采用溶栓治疗,抗血小板药物,阿托伐他汀,和心肌保护疗法。没有PGL的症状,CAE,或TTS在6个月的随访中出现，病人的生活质量很好。我们证实苯氧基苯甲胺是TTS的原因，因为心尖的反常收缩运动，下墙，左心室前壁,当PGL用苯氧苄胺治疗时，室间隔也同样恢复。
结论：为了提高对这种疾病的认识并防止误诊，我们在此介绍了一个由PGL和MarkisI型CAE带来的TTS病例，供临床医生参考。此外,在临床实践中，即使TTS是由PGL诱导的儿茶酚胺激增引起的,我们也应该考虑伴随冠状动脉疾病的可能性.
