scholarly journals Acute Heart Failure as a First Presentation of Pheochromocytoma Complicated with “Inverted” Takotsubo Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Jerrold Spapen ◽  
Jeroen de Filette ◽  
Stijn Lochy ◽  
Herbert Spapen
Keyword(s):  
Heart Failure ◽  
Pulmonary Oedema ◽  
Acute Heart Failure ◽  
Chromaffin Cells ◽  
Myocardial Injury ◽  
Takotsubo Syndrome ◽  
Healthy Patient ◽  
Lv Dysfunction ◽  
Paroxysmal Hypertension ◽  
Adrenal Pheochromocytoma

Takotsubo syndrome is a rare but emerging form of acute reversible myocardial injury characterized by transient systolic LV dysfunction, often related to emotional or physical stress. Pheochromocytoma is increasingly recognised as another possible trigger. Pheochromocytoma is a rare catecholamine-secreting tumour arising from chromaffin cells within the adrenal medulla or extra-adrenal paraganglia. The pathognomonic quartet of paroxysmal hypertension, palpitations, headache, and diaphoresis is rarely present, and diagnosis is often delayed. We describe a 43-year-old formerly healthy patient with an adrenal pheochromocytoma, presenting as an “inverted” takotsubo syndrome complicated with acute heart failure and pulmonary oedema.

Abstract 17352: Differences in Clinical Characteristics, Risk Factors, Rate of Recurrence and 1-year Outcome Between Acute Heart Failure Patients With Stroke or TIA and Those Without This Co-morbidity. Results From the Gulf aCute heArt failuRe rEgistry (gulf Care)

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Mohammed A Al Hashemi ◽  
Kadhim Sulaiman ◽  
Jassim Al-Suwaidi ◽  
Khalid F AlHabib ◽  
Husam AlFaleh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Clinical Characteristics ◽  
De Novo ◽  
Stroke Patients ◽  
Lv Dysfunction ◽  
Co Morbidity ◽  
History Of ◽  
One Year ◽  
Ischemic Attack

Background: Chronic heart failure (CHF) is a known risk for stroke and morbidities and mortalities are known to be higher in CHF patients compared to stroke patients without CHF we here study the prevalence and the clinical significance in a group of patient with stroke or transient ischemic attack (TIA) who were admitted to hospital with acute heart failure (AHF) compared to those without stroke and are admitted with acute heart failure Methods: Data were derived from a prospective, multicenter, multinational study of 5005 patients hospitalized with AHF from February 2013 to November 2012. Data were analyzed according to the presence or absence of Stroke or bronchial TIA. Demographic, management, in-hospital and 1-year outcomes were compared Results: Stroke patients were likely to have a decompensation of chronic failure rather than De-Novo AHF when compared to those without Stroke/TIA (see table). Stroke patients were older; more likely to be female, have history of DM, HTN, dyslipidemia and CKD. Stroke patients were likely to have Atrial fibrillation, PVD, systolic LV dysfunction as well as CAD when compared to those without Stroke, they were also more likely receive NIV, IV inotropes and likely to have had cardiac PCI prior to this admission with AHF. Stroke patients had higher recurrence of stroke and one-year mortality rates. Conclusion: Patients who presented with AHF and history of stroke/TIA were having different clinical characteristics as well as comorbidities as compared to those without Stroke, with worse in-hospital and one-year outcome. The current study underlies the need to aggressively manage these high-risk patients.

scholarly journals Acute-onset heart failure secondary to long-standing abuse of alcohol, cocaine, and marijuana

2018 ◽  
Vol 2 ◽  
pp. 239784731877072
Author(s):  
David B Chapel ◽  
Aliya N Husain
Keyword(s):  
Heart Failure ◽  
Differential Diagnosis ◽  
Alcohol Use ◽  
Dilated Cardiomyopathy ◽  
Myocardial Injury ◽  
Cardiac Injury ◽  
Clinical History ◽  
Acute Onset ◽  
Healthy Patient ◽  
Polysubstance Abuse

Acute-onset heart failure in a young, otherwise healthy patient can be due to either acquired or congenital etiologies. While some diagnoses carry specific histologic hallmarks, many causes of myocardial injury culminate in the relatively nonspecific morphologic pattern of dilated cardiomyopathy. In such cases, a broad differential diagnosis and close clinicopathologic correlation are essential. Here we describe the acute and chronic histologic features of heart failure arising in the context of long-standing abuse of cocaine, alcohol, and marijuana. The mechanisms of cardiotoxicity are discussed for each drug, with particular emphasis on the amplified cardiac injury caused by concomitant cocaine and alcohol use. Although its histologic features are themselves nonspecific, correlation with clinical history, targeted studies to exclude alternative diagnoses, and careful morphologic examination permit confident diagnosis of cardiomyopathy secondary to polysubstance abuse.

scholarly journals Acute heart failure: focusing on acute cardiogenic pulmonary oedema

2010 ◽  
Vol 10 (1) ◽  
pp. 59-64 ◽  
Author(s):  
John GF Cleland ◽  
Ashraf S Yassin ◽  
Kayvan Khadjooi
Keyword(s):  
Heart Failure ◽  
Pulmonary Oedema ◽  
Acute Heart Failure ◽  
Cardiogenic Pulmonary Oedema

scholarly journals Short‐ and Long‐Term Clinical Outcomes for Patients With Takotsubo Syndrome and Patients With Myocardial Infarction: A Report From the Swedish Coronary Angiography and Angioplasty Registry

2021 ◽  
Vol 10 (17) ◽  
Author(s):  
Björn Redfors ◽  
Sandeep Jha ◽  
Sigurdur Thorleifsson ◽  
Tomas Jernberg ◽  
Oskar Angerås ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Angiography ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Mortality Risk ◽  
Takotsubo Syndrome ◽  
Killip Class ◽  
St Segment Elevation ◽  
Similar Risk

Background Takotsubo syndrome (TS) is a potentially life‐threatening acute cardiac syndrome with a clinical presentation similar to myocardial infarction and for which the natural history, management, and outcome remain incompletely understood. Our aim was to assess the relative short‐term mortality risk of TS, ST‐segment–elevation myocardial infarction (STEMI), and non‐STEMI (NSTEMI) and to identify predictors of in‐hospital complications and poor prognosis in patients with TS. Methods and Results This is an observational cohort study based on the data from the SCAAR (Swedish Coronary Angiography and Angioplasty Registry). We included all patients (n=117 720) who underwent coronary angiography in Sweden attributed to TS (N=2898 [2.5%]), STEMI (N=48 493 [41.2%]), or NSTEMI (N=66 329 [56.3%]) between January 2009 and February 2018. We compared patients with TS to those with NSTEMI or STEMI. The primary end point was all‐cause mortality at 30 days. Secondary outcomes were acute heart failure (Killip Class ≥2) and cardiogenic shock (Killip Class 4) at the time of angiography. Patients with TS were more often women compared with patients with STEMI or NSTEMI. TS was associated with unadjusted and adjusted 30‐day mortality risks lower than STEMI (adjusted hazard ratio [adjHR], 0.60; 95% CI, 0.48–0.76; P <0.001), but higher than NSTEMI (adjHR, 2.70; 95% CI, 2.14–3.41; P <0.001). Compared with STEMI, TS was associated with a similar risk of acute heart failure (adjHR, 1.26; 95% CI, 0.91–1.76; P =0.16) but a lower risk of cardiogenic shock (adjHR, 0.55; 95% CI, 0.34–0.89; P =0.02). The relative 30‐day mortality risk for TS versus STEMI and NSTEMI was higher for smokers than nonsmokers (adjusted P interaction STEMI=0.01 and P interaction NSTEMI=0.01). Conclusions The 30‐day mortality rate in TS was higher than in NSTEMI but lower than STEMI despite a similar risk of acute heart failure in TS and STEMI. Among patients with TS, smoking was an independent predictor of mortality.

scholarly journals Acute decompensated heart failure: a study of nursing care

2020 ◽  
Vol 15 (3) ◽  
pp. 1-12
Author(s):  
Nicholas Woolfe Loftus ◽  
Tracey Bowden
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Pulmonary Oedema ◽  
Acute Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Clinical Signs ◽  
Decompensated Heart Failure ◽  
Medical Attention ◽  
Acute Decompensation ◽  
Care Study

This care study focuses on the initial acute phase of care for a patient with acutely decompensated heart failure. Heart failure is a syndrome characterised by clinical signs, such as pulmonary oedema, and symptoms, such as dyspnoea. Acute heart failure develops rapidly and requires urgent medical attention, unlike the slower insidious onset of chronic heart failure. Acute heart failure can be either new or acute decompensation of chronic heart failure. The patient presented with cardiogenic pulmonary oedema because of acute decompensation of his chronic heart failure. He agreed to medical management, which included continuous positive airway pressure, intra-arterial cannulation and a furosemide infusion. This treatment proved largely effective, but it may have been better if his furosemide infusion had been stopped sooner. The implications for practice are explored in this care study.

Burning issues in acute heart failure management

2019 ◽  
Vol 61 (6) ◽  
Author(s):  
J. A. Ker ◽  
K. Outhoff
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Chronic Heart Failure ◽  
Pulmonary Oedema ◽  
Acute Heart Failure ◽  
Heart Failure Management ◽  
Life Saving ◽  
End Stage ◽  
New Onset

In general, heart failure is the end-stage manifestation of cardiovascular disease and is an important and increasing cause of morbidity worldwide. Acute heart failure, whether of new onset or an exacerbation of chronic heart failure, causes sudden congestion, typically presenting as pulmonary oedema. The mortality associated with acute heart failure is extremely high. Potentially life-saving treatments and other burning issues are highlighted in this review.

scholarly journals Pheochromocytoma Presenting as Acute Heart Failure Leading to Cardiogenic Shock and Multiorgan Failure

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Jochen Steppan ◽  
Julia Shields ◽  
Ralph Lebron
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Multiorgan Failure ◽  
Young Male ◽  
Endocrine Tumor ◽  
Good Prognosis ◽  
Diagnostic Tools ◽  
Paroxysmal Hypertension ◽  
Plasma Metanephrines

Pheochromocytoma is an endocrine tumor classically presenting with headache, paroxysmal hypertension, and palpitations. We discuss the case of a young male, presenting with acute heart failure and cardiogenic shock requiring stabilization with an intra-aortic balloon pump and a combination of ionotropes and vasopressors. Pheochromocytoma was diagnosed by CT scan, as well as urine and plasma metanephrines. After pretreatment with phenoxy-benzamine, the patient underwent adrenalectomy with subsequent cardiovascular stabilization and full recovery. Unfortunately, pheochromocytoma often remains undiagnosed. Given the ample diagnostic tools and good prognosis when treated suitably, the diagnosis should be entertained early in patients, presenting with unexplained cardiovascular compromise.

scholarly journals Adrenal pheochromocytoma presenting with Takotsubo-pattern cardiomyopathy and acute heart failure

Medicine ◽  
2016 ◽  
Vol 95 (36) ◽  
pp. e4846 ◽  
Author(s):  
Yi-Lun Chiang ◽  
Pei-Chi Chen ◽  
Chin-Cheng Lee ◽  
Su-Kiat Chua
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Adrenal Pheochromocytoma
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