A case of pheochromocytoma presenting with Takotsubo cardiomyopathy as the first symptom without hypertension

Pheochromocytoma is a rare neuroendocrine tumor that can causes serious metabolic and cardiovascular complications. Pheochromocytoma rarely presents with Takotsubo cardiomyopathy and uncontrolled angina as the initial symptom without concomitant hypertension. A 42-year-old man with heart failure, chest pain, high levels of cardiac markers, and uncontrolled angina without hypertension caused by pheochromocytoma was examined for this report. Symptoms of Takotsubo cardiomyopathy and uncontrolled angina were improved and a correct diagnosis of pheochromocytoma was achieved. The patient successfully underwent adrenalectomy with good outcomes. The patient has remained asymptomatic for 2 years after surgery. Concentrations of catecholamines should be tested in patients who have atypical presentation of Takotsubo cardiomyopathy, which may reveal an underlying pheochromocytoma.