Pheochromocytoma and Takotsubo’s Cardiomyopathy Requiring Extracorporeal Membrane Support: A Report of Two Cases and Review of Takotsubo’s Cardiomyopathy Subtypes
Bibliographic record
Abstract
Pheochromocytoma/Paraganglioma (PPGL) are rare neuroendocrine catecholamine secreting tumours that may vary widely in their clinical presentation. Previous case series describe 12% of PPGL patients initially presenting with cardiac complications. Pheochromocytoma-related Takotsubo’s cardiomyopathy has been well described in the literature and may present with primarily basal dyskinesis (inverted subtype), apical dyskinesis (classic subtype), or global dyskinesis. Basal dyskineses has been more commonly described in pheochromocytoma-related Takotsubo’s cardiomyopathy. We present two cases of severe cardiogenic shock requiring Extra-Corporeal Membrane Support (ECMO) with Takotsubo’s cardiomyopathy secondary to pheochromocytoma at University Health Network, Toronto. In both cases, the pheochromocytoma was incidentally discovered on imaging. Both patients responded favourably to ECMO and alpha-adrenergic blockade with recovery of ejection fraction. Both received adrenalectomy as an outpatient with successful recovery. Although rare, PPGL should be considered in younger patients presenting with severe unexplained cardiogenic shock and Takotsubo’s cardiomyopathy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".