일과성 뇌허혈과 심근병증으로 발현한 갈색세포종 1예
A Case of Transient Ischemic Attack and Cardiomyopathy Presented with Pheochromocytoma
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본 증례에서 환자는 내원 6개월 전 일과성 뇌허혈이 있었고, 흉통을 호소하며 내원하여 심전도 및 심근효소에서 급성관상동맥 증후군이 의심되어 관상동맥조영술을 시행하였으나 관상동맥에는 특이 소견이 없었고, 좌심실 조영술에서 Takotsubo 심근병증 양상으로 나타났다. 내원 6개월 전에 있었던 일과성 뇌허혈 및 Takotsubo 심근병증이 모두 갈색세포종에서 드물게 보일 수 있는 양상이었으며, 발작적인 고혈압, 두통, 심계항진 등의 동반 증상 등으로 갈색세포종을 의심하였고, 복부 전산화단층촬영 및 24시간 요 카테콜라민 검사에서 확인이 되어 수술적 치료로 호전이 된 증례이다.
Abstract
Patients with pheochromocytoma show a variety of clinical symptoms secondary to excessive catecholamine secretion. Major symptoms include hypertension, headache, hyperhidrosis, and palpitation. Stroke and myocardial infarction are known to occur in patients with pheochromocytoma, but the incidence is low. Here, we describe a 45-year-old female with a previous history of transient ischemic attack and a clinical presentation mimicking acute myocardial infarction with transient takotsubo-like myocardial dysfunction. A subsequent diagnostic examination revealed a left adrenal pheochromocytoma. The patient recovered with intensive medical treatment, including alpha- and beta-adrenergic blockade. Follow-up echocardiography revealed normalized cardiac function and wall motion. Thereafter, the patient underwent a laparoscopic left adrenalectomy without complications. (Korean J Med 2012;83:232-237)
참고문헌 (10)
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