Atypical variant takotsubo cardiomyopathy secondary to pheochromocytoma

A 39-year-old woman presented with chest pain and elevated troponin levels. Cardiac catheterization demonstrated no coronary artery disease, with findings consistent with atypical variant takotsubo cardiomyopathy. Further workup showed elevated plasma fractionated metanephrines suggestive of pheochromocytoma. Abdominal imaging showed a right adrenal mass, with surgical excision and histopathological evaluation confirming a pheochromocytoma. Pheochromocytomas are a rare cause of takotsubo-like syndrome with an atypical takotsubo variant rarer still.