A case of pheochromocytoma-induced post-partum stress cardiomyopathy
2 U.O. Cardiologia 1, Azienda Ospedaliera Universitaria Pisana, Pisa
Abstract
La cardiomiopatia peripartum e la cardiomiopatia Takotsubo durante il peripartum presentano caratteristiche cliniche simili. Entrambe le patologie si presentano con scompenso cardiaco acuto e disfunzione ventricolare sinistra nel periodo peripartum in donne che non hanno precedenti cardiovascolari. È importante una corretta diagnosi differenziale per migliorarne l’approccio terapeutico e il follow-up. L’imaging cardiovascolare influenza in maniera fondamentale la definizione diagnostica, l’indirizzo terapeutico e il follow-up di tali pazienti. Sono necessari ulteriori studi che definiscano meglio l’eziologia e la diagnosi differenziale tra queste due patologie, la cui prognosi è sostanzialmente differente. In particolare, pazienti che hanno avuto una cardiomiopatia peripartum devono essere messe a conoscenza dei potenziali rischi associati ad una successiva gravidanza.
Parole chiave: Cardiomiopatia peripartum; Cardiomiopatia Takotsubo; Imaging cardiaco; Feocromocitoma.
Abstract
There are some similarities in clinical features between Takotsubo cardiomyopathy during the peripartum period and peripartum cardiomyopathy. Both conditions present as acute heart failure and decreased left ventricular (LV) ejection fraction in the peripartum period in previously heart-healthy women. Although LV dysfunction is similar at the initial diagnosis, the prognosis of LV recovery is more favorable in PTCM than in PPCM. Therefore, physicians should differentiate these two diseases entities, although they have several similarities in acute LV dysfunction. Cardiac imaging plays a key role in the differential diagnosis, therapy and follow-up of peripartum women with signs and symptoms of heart failure. Apart from small registries, to the best of our knowledge, no study has investigated the difference between these two diseases entities, so that they may be confused with each other. Women undergoing a subsequent pregnancy with an impaired systolic function are at substantial risk for relapse and death and should therefore be made aware of the risk of subsequent pregnancies.
Key words: Peripartum cardiomyopathy; Takotsubo cardiomyopaty; Cardiac imaging; Pheochromocytoma.
