Cardiac paraganglioma

Arquivos Brasileiros de Cardiologia, 2011

Polskie Archiwum Medycyny Wewnetrznej, 2016

The Journal of Emergency Medicine, 2013

Background: Apical ballooning syndrome (ABS) or stress cardiomyopathy is increasingly recognized as a cause of acute coronary syndrome with unobstructed coronaries, but remains underdiagnosed. Objectives: Retrospective review of the angiographic database (between January 2006 and December 2010) to obtain incidence and clinical presentation of ABS at our center. ABS was defined according to the modified Mayo Clinic criteria. Case Results: Normal or unobstructed coronaries on angiography were observed in 1780 (25.4%) of a total of 6983 patients who underwent urgent or emergency coronary angiography. Twelve patients (0.17%) fulfilled the modified Mayo Clinic criteria for ABS. Eleven patients (92%) were aged $ 50 years (median 68 years, range 27-86 years), and 10 were female (83%). Four patients (31%) presented with STelevation myocardial infarction, and 1 patient presented with cardiogenic shock and acute coronary syndrome. Emotional stress was the precipitant in 4 patients (33%). Unusual precipitants like cold-water immersion and intravenous chemotherapy were observed. All 12 patients had the typical appearance of ABS on left ventriculogram (75%) or echocardiography (25%). Follow-up imaging with either echocardiography or magnetic resonance imaging (done in all 12 patients) up to 16 weeks after discharge showed that left ventricular function had normalized. Conclusions: The incidence and clinical features of ABS in our tertiary center are similar to those reported in other settings. Unusual precipitants were observed, but left ventriculograms were performed less frequently and could be contributory to the under-diagnosis of ABS. Ó 2013 Elsevier Inc.

Arquivos Brasileiros de Cardiologia, 2012

Arquivos Brasileiros De Cardiologia, 2011

pressure 70/40 mm Hg. Heart and lung semiology was considered normal. Abdominal examination was normal and had no lower limb edema. Electrocardiogram (March 4) showed sinus rhythm, heart rate 75 bpm, PR 160 ms interval, QRS 80 ms duration, SÂQRS +30° backwards and abnormalities in ventricular repolarization (fig. 1). Laboratory tests (March 4) revealed hemoglobin 11.3 g/ dl, hematocrit 35%, mean corpuscular volume 85 fL, platelet 281,000/mm³, leukocytes 14,400/mm (neutrophils 81%, eosinophils 1%, lymphocytes 11% and monocytes 7%), creatinine 0.93 mg/dl, urea 42 mg/dl, sodium 145 mEq/l, potassium 3.4 mEq/l, C-reactive Protein 172 mg/l, troponin I < 0.20 ng/ml, CKMB 2,17 ng/ml, prothrombin time (INR) 1.2 and activated partial thromboplastin time ratio 0.89. Echocardiography (March 4) revealed preserved biventricular function, left ventricular hypertrophy in appearance, moderate to severe pericardial effusion, with no signs of restriction to ventricular filling.

Circulation, 2012

Arquivos Brasileiros de Cardiologia, 2010

Cleveland Clinic Journal of Medicine, 2009

A 37-year-old man with chest pain, ECG changes, and elevated cardiac enzymes A 37-year-old African American man presents to the emergency department with chest pain and dyspnea, which began suddenly 30 minutes ago. The pain is severe, pressure-like, nonradiating, and pleuritic.

AACE Clinical Case Reports, 2020

Objective: The objective of this report is to present 2 cases of cardiac paragangliomas (PGLs), and to outline the presentation, management, and associated genetic mutations. Methods: Case 1, a 38-year-old female, presented with a 12-month history of paroxysmal palpitations, headaches, and weight loss. Her investigations included plasma free metanephrines and urinary metanephrines, 68-gallium DOTATATE positron emission tomography/computed tomography, and cardiac imaging. Case 2, a 28-year-old male, presented with a hypertensive crisis and abdominal pain on a background of hypertension. Given his abdominal pain, he was investigated with an abdominal computed tomography (CT) scan, followed by plasma free metanephrines and urinary metanephrines, echocardiogram, and 123-iodine meta-iodobenzylguanidine single-photon emission CT. Results: Case 1 had an elevated plasma normetadrenaline of 6,750 pmol/L (reference range is <900 pmol/L) and 3-methoxytyramine of 1,845 pmol/L (reference range is <110 pmol/L). 68-gallium DOTATATE positron emission tomography/computed tomography showed an avid Abbreviations: CT = computed tomography; MRI = magnetic resonance imaging; PGL = paraganglioma; SDH = succinate dehydrogenase Plasma free metanephrines Reference range

The Netherlands journal of medicine, 2015

Paragangliomas commonly produce one or more types of catecholamines: epinephrine, norepinephrine and dopamine. High levels of catecholamines can result in cardiovascular complications, varying from hypertension and palpitations to acute ventricular dysfunction due to a catecholamine-induced cardiomyopathy. Stress cardiomyopathy (or Takotsubo cardiomyopathy) is an acute, transient ventricular dysfunction displaying severe left ventricular wall motion abnormalities. It often mimics an acute coronary syndrome in the absence of coronary artery disease. Precipitants of Takotsubo cardiomyopathy are numerous but catecholamine mediated β2-adrenoceptor stimulation is thought to be an important common component in the aetiology.