Letter to the editor
Pheochromocytoma-induced ventricular tachycardia and reversible cardiomyopathy

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Abstract

A case of a 48-year-old male is described with recurrent paroxysmal ventricular tachycardia originating near the region of the posterior fascicle, as an initial presentation of a primary norepinephrine producing pheochromocytoma, including reversible catecholamine-induced cardiomyopathy. The ventricular arrhythmia was terminated by procainamide and labetalol. After adrenalectomy no recurrent ventricular arrhythmia was observed.

Section snippets

Case report

A 48-year-old male was admitted to the emergency department with episodic retrosternal discomfort and extreme headache. During these episodes the arterial blood pressure (240/130 mm Hg) and pulse rate were raised (180 bpm), also there was flushing of the superior thorax. Within 10 min there was spontaneous recovery with relief of symptoms and normalization of hemodynamic parameters. These paroxysms recommenced within time frames of 20 min.

We observed a rapidly increasing sinus rate, converting into

Discussion

This case is reported because of the prominent clinical and arrhythmic features, and the marked reversibility of the clinical condition. Pheochromocytoma is a catecholamine producing tumor that originates from the adrenal medulla or extra-adrenal chromaffin cells. Hypertension can be persistent, paroxysmal or absent. Electrocardiographic manifestations such as sinus tachycardia, transient ST segment deviation, paroxysmal supraventricular tachycardia, atrial fibrillation, ventricular premature

Conclusion

Monomorphic ventricular tachycardia with an origin near the region of the posterior fascicle is described as part of an impressive clinical manifestation of a pheochromocytoma, including an atypical cathecholamine-induced cardiomyopathy with reversible systolic left ventricular dysfunction. Both procainamide and labetalol successfully terminated the ventricular tachycardia. Labetalol also suppressed the underlying sinus tachycardia and the hypertensive crises and was thus found to be more

Acknowledgement

The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [7].

References (7)

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