Recurrent tako–tsubo–like left ventricular dysfunction (apical ballooning) in a patient with pheochromocytoma—a case report

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Abstract
Primarily described in Japan, tako–tsubo–like left ventricular dysfunction is a phenomenon characterized by transient apical ballooning in the absence of significant coronary artery disease. The clinical presentation includes symptoms like chest pain, dyspnea, syncope, electrocardiographic changes and elevated myocardial markers, all compatible with the diagnosis of an acute coronary syndrome. The underlying mechanism is supposed to be a catecholamine excess caused by various triggers. We describe a patient with a recurrent tako–tsubo phenomenon, who at work–up proved to have a pheochromocytoma as the most likely underlying disease.