カテコールアミン心筋症を合併した褐色細胞腫の1症例

Abstract

A 40-year-old female with the left adrenal pheochoromocytoma showed ECG abnormalities and the clinical features similar to acute myocardial infarction. Enzymological studies and UCG findings in the acute phase revealed the same pattern as those in acute myocardial infarction. After finding the existence of the left adrenal pheochromocytoma, the differential diagnosis between myocardial infarction and catecholamine cardiomyopathy as the cause of ECG, UCG and enzymological changes was tried to make. However, the differential diagnosis was not established during the preoperative period. The continued ECG abnormilities until the surgical removal of the tumor disappeared one week after the operation. Norepinephrine infusion test performed one and two weeks and 21 months after the operation could evoke the T wave change which disappeared soonly after norepinephrine infusion was stopped. Coronary angiography and 201Tl myocardial scintigraphy revealed the normal findings. These findings suggested that catecholamines released from pheochromocytoma was the cause of the myocardial damages and ECG abnormalities. The patient with catecholamine cardiomyopathy due to the adrenal pheochromocytoma whose ECG abnormalities continued until surgical treatment was reported

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