The Korean Journal of Medicine

  • 제87권1호
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  • Pages.77-80
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  • 2014
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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좌심실 혈전을 동반한 스트레스 유발 심근병증으로 발현된 갈색세포종 1예

A Case of Pheochromocytoma Presenting as Stress-Induced Cardiomyopathy with Large Left Ventricular Thrombus

  • 장덕현 (세종병원 내과 및 세종의학연구소) ;
  • 박진식 (세종병원 내과 및 세종의학연구소) ;
  • 강명신 (세종병원 내과 및 세종의학연구소) ;
  • 김태훈 (세종병원 내과 및 세종의학연구소) ;
  • 신동희 (세종병원 내과 및 세종의학연구소) ;
  • 이지혜 (세종병원 내과 및 세종의학연구소) ;
  • 채명준 (세종병원 내과 및 세종의학연구소)
  • Jang, Duck Hyun (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Park, Jinsik (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Kang, Myung Shin (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Kim, Tae Hoon (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Shin, Dong Hee (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Lee, Ji Hye (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Chae, Myung Joon (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital)
  • 투고 : 2013.07.09
  • 심사 : 2013.08.26
  • 발행 : 2014.07.01
⟨ 이전 논문 다음 논문 ⟩

초록

젊은 나이의 환자에서 다양한 임상증상 및 대사 질환을 가지고 있을 경우 갈색세포종을 고려해야 하며, 원인을 알 수 없는 심근병증의 감별진단의 하나로 갈색세포종을 생각할 수 있다.

The clinical presentation of pheochromocytoma is variable. The classic symptoms are headache, diaphoresis, and tachycardia, with paroxysmal hypertension. Other less common cardiovascular manifestations, such as arrhythmias, angina pectoris, acute myocardial infarction, dilated cardiomyopathy, and acute heart failure, have been reported occasionally. We present the case of a middle-aged woman who had stress-induced cardiomyopathy with a left ventricular thrombus, due to the pheochromocytoma. The thrombus was embolized to the aorto-iliac bifurcation during hospitalization. We removed the thrombus by a catheter thromboembolectomy and performed a surgical left adrenalectomy. After the operation, all of her symptoms and the underlying diseases (hypertension, hyperglycemia, heart failure, dyslipidemia) resolved.

키워드

참고문헌

  1. Pacak K, Linehan WM, Eisenhofer G, Walther MM, Goldstein DS. Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Ann Intern Med 2001;134:315-329. https://doi.org/10.7326/0003-4819-134-4-200102200-00016
  2. Lenders JW, Eisenhofer G, Mannelli M, Pacak K. Phaeochromocytoma. Lancet 2005;366:665-675. https://doi.org/10.1016/S0140-6736(05)67139-5
  3. Kim DS, Kim KR, Yoon HJ, et al. Two cases of pheochromocytoma associated with acute myocardial infarction. Korean J Med 1999;57:357-363.
  4. Sanchez-Recalde A, Costero O, Oliver JM, Iborra C, Ruiz E, Sobrino JA. Images in cardiovascular medicine: pheochromocytoma-related cardiomyopathy: inverted Takotsubo contractile pattern. Circulation 2006;113:e738-739. https://doi.org/10.1161/CIRCULATIONAHA.105.581108
  5. Van de Walle SO, Gevaert SA, Gheeraert PJ, De Pauw M, Gillebert TC. Transient stress-induced cardiomyopathy with an "inverted takotsubo" contractile pattern. Mayo Clin Proc 2006;81:1499-1502. https://doi.org/10.4065/81.11.1499
  6. Aurigemma GP. Acute stress cardiomyopathy and reversible left ventricular dysfunction. Cardiol Rounds 2006;10:1-6.
  7. Ikaheimo MJ, Takkunen JT. Echocardiography in acute infectious myocarditis. Chest 1986;89:100-102. https://doi.org/10.1378/chest.89.1.100
  8. Tomioka N, Kishimoto C, Matsumori A, Kawai C. Mural thrombus in experimental viral myocarditis in mice: relation between thrombosis and congestive heart failure. Cardiovasc Res 1986;20:665-671. https://doi.org/10.1093/cvr/20.9.665
  9. Asinger RW, Mikell FL, Elsperger J, Hodges M. Incidence of left-ventricular thrombosis after acute transmural myocardial infarction: serial evaluation by two-dimensional echocardiography. N Engl J Med 1981;305:297-302. https://doi.org/10.1056/NEJM198108063050601
  10. Choi JB, Koh KP. Surgical removal of a pedunculated left ventricular thrombus. Korean J Thorac Cardiovasc Surg 2000;33:190-192.