閉塞性肥大型心筋症類似の左室形態を示した褐色細胞腫の1症例

A case of pheochromocytoma with left ventricular configuration mimicking hypertrophic obstructive cardiomyopathy

　褐色細胞腫は腫瘍より分泌される過剰なカテコラミンにより多彩な臨床症状を呈するが，心臓への影響も大きく，カテコラミン心筋炎として注目されている^1〜4）。

　一方，カテコラミンは心筋肥大の成因の1つとしてもその重要性が認められている^5）。

We report a case of pheochromocytoma in which echocardiographic features mimicking hypertrophic obstructive cardiomyopathy (HOCM). Case was a 56-year-old man. He complained of spells of headache and palpitation accompanied by hyper-tension. The patient was hospitalized for evaluation of labile hypertension. On admission on December 21, 1982, the pulse was 96 beats/min and blood pressure was 140/100 mmHg, without postural hypotension. A 24-hour urine collection showed elevated catecholamines and a computed tomogra-phic (CT) scan of the abdomen demonstrated a right adrenal mass. Two-dimensional echocardio-graphy revealed asymmetric septal hypertrophy (ASH) and an M-mode echocardiogram showed systolic anterior movement (SAM) of the mitral valve and midsystolic closure of the aortic valve. On March 23, 1983, a right adrenal pheochromo-cytoma was removed without complication. Post-operatively the patient was asymptomatic and normal blood pressure. Echocardiographic features simulating HOCM disappeared following surgical removal of the tumor. These findings indicate that left ventricular outflow tract obstruction observed in the patient is the dynamic obstruction produced by excessive catecholamines.