Aleksan Khachatryan1*, Ashot Batikyan2, Justin Brilliant3, Mukta C. Srivastava4, Margarita Sargsyan5, Hakob Harutyunyan6, Vahagn Tamazyan7 and Joel Alejandro8

Takotsubo cardiomyopathy (TTC) is characterized by transient left ventricular systolic dysfunction and can have various physical and emotional triggers, including pheochromocytomas. Pheochromocytoma is a rare neuroendocrine tumor associated with hypertension, orthostatic hypotension, tachyarrhythmias, myocardial infarction, and cardiomyopathies. TTC is a recognized complication of pheochromocytoma and can be life-threatening in severe cases, sometimes requiring mechanical circulatory support. One of the proposed mechanisms for pheochromocytoma-induced TTC is coronary vasospasm. This review includes a clinical observation illustrating coronary vasospasm leading to TTC and cardiogenic shock in a patient with pheochromocytoma. We conducted an extensive literature search to identify all the cases of TTC attributed to pheochromocytoma-induced coronary vasospasm. This review aims to provide a comprehensive summary of the latest research, encompassing the pathophysiology, diagnostic findings, and treatment approaches for TTC in the context of pheochromocytoma.

Keywords: tako-tsubo cardiomyopathy (TTC), pheochromocytoma, pheochromocytoma crisis, coronary vasospasm, apical ballooning, catecholamine, cardiogenic shock, VA-ECMO, left ventricular outflow tract obstruction (LVOT), doxazosin

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