Pheochromocytoma unmasked by stress cardiomyopathy.

tress-induced cardiomyopathy was first described in Japan in 1990 and current medical knowledge is limited.Literature review revealed different underline causes of this cardiomyopathy. [1]Takotsubo syndrome is often triggered by a surge of stress hormones like cortisol, adrenaline and noradrenalin which put heart on sudden stress, causing temporary damages. [2]This syndrome can be defined as rapidly reversible heart failure (HF) that usually mimics the acute myocardial infarction (AMI) symptoms associated with characteristic regional wall motion abnormality without involvement of specific coronary artery territories. [3]Takotsubo syndrome can be classified in four types of apical type with apical akinesia and basal hypercontractility.Reverse type: basal akinesia and apical hypercontractility; midventricular type: midventricular ballooning and basal/apical hypercontraction and localized type. [4]Takotsubo syndrome is more common in postmenopausal woman (96%) while occurrence in younger group is relatively rare. [5]Also in the last decades, the frequency of the Takotsubo syndrome diagnosis is increasing but initial diagnosis remain challenging due to common similarities between Takotsubo syndrome and ST elevation myocardial infarction (STEMI). [6]Takotsubo syndrome probably accounts for 1%-2% of all the patients with suspected to AMI. [7] Although there is typically rapid and full spontaneous recovery of left ventricular function, long term follow up of these patients are not determined with large case control studies. [8]Intense, emotional, psychological and physical stresses such as grief, fear or sadness may also play a trigger role for Takotsubo syndrome. [9]Chronic anxiety