Preview

Rational Pharmacotherapy in Cardiology

Advanced search

ACUTE DECOMPENSATION OF HYPERTENSIVE HEART DISEASE IN PATIENT WITH MALIGNANT URINARY BLADDER PARAGANGLIOMA: STAGES OF DIAGNOSTICS AND TREATMENT

https://doi.org/10.20996/1819-6446-2018-14-3-370-378

Full Text:

Abstract

Hypertensive heart disease with biventricular cardiac failure is not common in clinical practice. This diagnosis requires an extensive diagnostic search. We present the clinical case of the male patient of 38 aged. He was admitted to the clinic with heart failure 3-4 NYHA class. EchoCG revealed symmetric hypertrophy of the left ventricle up to 18 mm without its dilatation, a decrease in ejection fraction up to 42%, restrictive hemodynamics, overload of the right chambers, severe pulmonary hypertension (60 mm Hg). The clinical status included persistent arterial hypertension (180-220 and 120-150 mm Hg), effusion in both pleural cavities and pericardium, ascites, renal failure. During examination (multispiral computed tomography, magnetic resonance imaging, scintigraphy with 131I-MIBG), bladder paraganglioma was diagnosed (normatenafrin 1468 μg/day). The resection of the tumor was performed, according to immunohistochemical research – neuroendocrine carcinoma, G1. After 3 months a partial regression of hypertension and cardiac failure was observed with the preservation of a high level of creatinine. The criteria and differential diagnosis of the hypertensive heart disease and the syndrome of primary myocardial hypertrophy, diagnostics of the urinary bladder paraganglioma, complex mechanisms of myocardial damage within the pheochromocytoma and its prognosis are discussed.

About the Authors

O. V. Blagova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Professor, Chair of Faculty Therapy No.1,

Trubetskaya ul. 8-2, Moscow, 119991



I. N. Alijeva
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, Cardiologist, Department of Cardiology No.2, University Clinical Hospital No.1,

Trubetskaya ul. 8-2, Moscow, 119991



E. A. Bezrukov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Professor, Chair of Urology; Head of Urological Department №1, University Clinical Hospital No.2,

Trubetskaya ul. 8-2, Moscow, 119991



L. I. Ippolitov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Head of Surgical Department, University Clinical Hospital No.1,

Trubetskaya ul. 8-2, Moscow, 119991



G. V. Polunin
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Surgeon, University Clinical Hospital No.1,

Trubetskaya ul. 8-2, Moscow, 119991



E. A. Kogan
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Professor, Head of Chair of Pathological Anatomy named after Academician A. I. Strukov,

Trubetskaya ul. 8-2, Moscow, 119991



V. V. Sedov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Professor, Chair of Radiology Diagnostic,

Trubetskaya ul. 8-2, Moscow, 119991



E. A. Mershina
Federal Center of Treatment and Rehabilitation
Russian Federation

MD, PhD, Head of Tomography Department, Center for Radiation Diagnostics,

Ivankovskoe shosse 3, Moscow, 125367



V. E. Sinitsyn
Federal Center of Treatment and Rehabilitation
Russian Federation

MD, PhD, Professor, Head of Center for Radiation Diagnostics,

Ivankovskoe shosse 3, Moscow, 125367



N. D. Sarkisova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Head of Cardiology department №2, University Clinic №1,

Trubetskaya ul. 8-2, Moscow, 119991



A. V. Nedostup
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Professor, Chair of Faculty Therapy No.1,

Trubetskaya ul. 8-2, Moscow, 119991



V. V. Fomin
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Professor, Corresponding Member of the Russian Academy of Sciences, Head of Chair of Faculty Therapy No.1,

Trubetskaya ul. 8-2, Moscow, 119991



References

1. Maron B.J., Maron M.S. A Discussion of Contemporary Nomenclature, Diagnosis, Imaging, and Management of Patients With Hypertrophic Cardiomyopathy. Am J Cardiol. 2016;118(12):1897-907. doi: 10.1016/j.amjcard.2016.08.086.

2. Frustaci A., Francone M., Petrosillo N., Chimenti C. High prevalence of myocarditis in patients with hypertensive heart disease and cardiac deterioration. Eur J Heart Fail. 2013;15(3):284-91. doi: 10.1093/eurjhf/hfs169.

3. Elliott P.M., Anastasakis A., Borger M.A. et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014;35(39):2733-79. doi: 10.1093/eurheartj/ehu284.

4. Rosmini S., Biagini E., O'Mahony C. et al. Relationship between aetiology and left ventricular systolic dysfunction in hypertrophic cardiomyopathy. Heart. 2017;103(4):300-6. doi: 10.1136/heartjnl2016-310138.

5. Blagova O.V., Nedostup A.V., Kogan E.A. et al. The Materials of Russian national congress of cardiology "Innovations and progress in cardiology" (Kazan, September 24-26, 2014). Kazan: RCS; 2014: P. 82. (In Russ) [Благова О.В., Недоступ А.В., Коган Е.А. и др. Результаты клинико-морфологической диагностики при первичном синдроме гипертрофии миокарда. Материалы Российского национального конгресса кардиологов «Инновации и прогресс в кардиологии» (Казань, 24-26 сентября 2014 г.). Казань: РКО; 2014: С. 82].

6. Menon S., Goyal P., Suryawanshi P. et al. Paraganglioma of the urinary bladder: a clinicopathologic spectrum of a series of 14 cases emphasizing diagnostic dilemmas. Indian J Pathol Microbiol. 2014; 57(1):19-23. doi: 10.4103/0377-4929.130873.

7. Kouba E., Cheng L. Neuroendocrine Tumors of the Urinary Bladder According to the 2016 World Health Organization Classification: Molecular and Clinical Characteristics. Endocr Pathol. 2016;27(3):188-99. doi: 10.1007/s12022-016-9444-5.

8. Beilan J.A., Lawton A., Hajdenberg J., Rosser C.J. Pheochromocytoma of the urinary bladder: a systematic review of the contemporary literature. BMC Urol. 2013;13:22.doi: 10.1186/1471-2490- 13-22.

9. Li Y., Guo A., Tang J. et al. Evaluation of sonographic features for patients with urinary bladder paraganglioma: a comparison with patients with urothelial carcinoma. Ultrasound Med Biol. 2014;40(3):478-84. doi: 10.1016/j.ultrasmedbio.2013.10.014.

10. Ferreira V.M., Marcelino M., Piechnik S.K. et al. Pheochromocytoma Is Characterized by Catecholamine-Mediated Myocarditis, Focal and Diffuse Myocardial Fibrosis, and Myocardial Dysfunction. J Am Coll Cardiol. 2016; 67(20):2364-74. doi: 10.1016/j.jacc.2016.03.543

11. Giavarini A., Chedid A., Bobrie G. et al. Acute catecholamine cardiomyopathy in patients with phaeochromocytoma or functional paraganglioma. Heart. 2013;99(19):1438-44. doi: 10.1136/heartjnl-2013-304073.

12. Gagnon N., Mansour S., Bitton Y., Bourdeau I. Takotsubo-like cardiomyopathy in a large cohort of patients with pheochromocytoma and paraganglioma. Endocr Pract. 2017;23(10):1178-1192. doi: 10.4158/EP171930.OR.

13. Imaoka C., Kanemoto N. [Pheochromocytoma with normal blood pressure and dilated cardiomyopathy: a case report]. J Cardiogr. 1986;16(3):735-45.

14. Brilakis E.S., Young W.F.Jr., Wilson J.W. et al. Reversible catecholamine-induced cardiomyopathy in a heart transplant candidate without persistent or paroxysmal hypertension. J Heart Lung Transplant. 1999;18(4):376-80.

15. Yu R., Nissen N.N., Bannykh S.I. Cardiac complications as initial manifestation of pheochromocytoma: frequency, outcome, and predictors. Endocr Pract. 2012;18(4):483-92. doi: 10.4158/EP11327.OR.

16. Zhang R., Gupta D., Albert S.G. Pheochromocytoma as a reversible cause of cardiomyopathy: Analysis and review of the literature. Int J Cardiol. 2017; 249:319-323. doi: 10.1016/j.ijcard.2017.07.014.


For citation:


Blagova O.V., Alijeva I.N., Bezrukov E.A., Ippolitov L.I., Polunin G.V., Kogan E.A., Sedov V.V., Mershina E.A., Sinitsyn V.E., Sarkisova N.D., Nedostup A.V., Fomin V.V. ACUTE DECOMPENSATION OF HYPERTENSIVE HEART DISEASE IN PATIENT WITH MALIGNANT URINARY BLADDER PARAGANGLIOMA: STAGES OF DIAGNOSTICS AND TREATMENT. Rational Pharmacotherapy in Cardiology. 2018;14(3):370-378. (In Russ.) https://doi.org/10.20996/1819-6446-2018-14-3-370-378

Views: 106


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)