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A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
High incidence of cardiovascular complications in pheochromocytoma
T Zelinka1, O Petrák, H Turková
1Center for Hypertension, 3rd Medical Department-Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, U Nemocnice 1, Prague, Czech Republic. tzeli@lf1.cuni.cz
Insights
Pheochromocytoma, a tumor causing excess catecholamines, is linked to a high incidence of cardiovascular complications like arrhythmias and heart attacks. Early diagnosis of pheochromocytoma is crucial to prevent these severe outcomes.
Area of Science:
- Endocrinology
- Cardiology
- Oncology
Background:
- Pheochromocytoma is a rare tumor of the adrenal medulla that secretes excess catecholamines.
- Elevated catecholamines can lead to significant cardiovascular complications, often presenting with classical symptoms.
- However, cardiovascular issues can also occur without typical pheochromocytoma signs, necessitating broader awareness.
Purpose of the Study:
- To retrospectively analyze the incidence of cardiovascular complications in patients diagnosed with pheochromocytoma.
- To identify specific types of cardiovascular events associated with pheochromocytoma.
- To emphasize the importance of early pheochromocytoma diagnosis for preventing severe cardiovascular sequelae.
Main Methods:
- Retrospective analysis of 145 patients treated for pheochromocytoma.
- Classification of cardiovascular complications into arrhythmias, myocardial involvement/ischemia/atherosclerosis, and cerebrovascular impairment.
- Comparison of patients with and without cardiovascular complications regarding clinical and biochemical parameters.
Main Results:
- Cardiovascular complications were observed in 19.3% (28/145) of patients.
- Arrhythmias (atrial fibrillation, supraventricular tachycardia, ventricular tachycardia, bradycardia) were most common (15 cases).
- Other complications included heart failure, myocardial infarction, and cerebrovascular events, occurring irrespective of patient demographics or tumor characteristics.
Conclusions:
- Pheochromocytoma is associated with a substantial incidence of cardiovascular complications.
- These complications can manifest diversely, including arrhythmias, ischemic events, and heart failure.
- Prompt diagnosis and management of pheochromocytoma are essential to mitigate the risk of severe cardiovascular morbidity.
Abstract:
Excess of catecholamines in pheochromocytoma is usually accompanied with classical symptoms and signs. In some cases, severe cardiovascular complications (e. g., heart failure, myocardial infarction) may occur. We performed a retrospective analysis focused on the incidence of cardiovascular complications (classified as follows: arrhythmias, myocardial involvement or ischemia and atherosclerosis, cerebrovascular impairment) before the establishment of diagnosis of pheochromocytoma among 145 subjects treated in our hospital. Cardiovascular complications occurred in 28 subjects, but these subjects did not differ significantly from subjects without complications in age, gender, body mass index, paroxysmal symptoms, symptom duration, tumor dimension, catecholamine secretory phenotype, and incidence of hypertension or diabetes mellitus. Arrhythmias occurred in 15 subjects (2 arrhythmia types in 2 subjects): atrial fibrillation in 9 subjects, supraventricular tachycardia in 3 cases, and ventricular tachycardia in 2 patients. Significant bradycardia was noted in 3 cases. Five subjects presented with heart failure with decreased systolic function (takotsubo-like cardiomyopathy found in 2 cases). One subject suffered from hypertrophic obstructive cardiomyopathy. Seven subjects presented with non-ST-segment elevation myocardial infarction, 2 patients with ST-segment myocardial infarction, and 1 subject underwent coronary artery bypass grafting. Two subjects suffered from significant peripheral atherosclerosis. Among cerebrovascular complications, transient ischemic attack was found in 3 cases, 2 subjects suffered from stroke, and subarachnoidal bleeding occurred in 1 patient. One subject suffered from diffuse neurological impairment due to multiple ischemic white matter lesions. These data show relatively high incidence of cardiovascular complications (19.3%) in subjects with pheochromocytoma. Early diagnosis is mandatory to prevent severe complications in pheochromocytoma.
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