Hyperadrenergic Crisis and Takotsubo Cardiomyopathy: A Review

Hyperadrenergic crisis, characterized by excessive catecholamine activity, can lead to severe cardiovascular complications, including Takotsubo cardiomyopathy (TCM). Various conditions, such as pheochromocytoma, endocrine disorders, and adrenergic drug withdrawal, contribute to this syndrome. Understanding the underlying mechanisms is essential for appropriate diagnosis and management. A comprehensive literature review was conducted, analyzing case reports, clinical studies, and pathophysiological data related to hyperadrenergic crisis and its impact on myocardial function. Diagnostic approaches and treatment strategies were evaluated. Pheochromocytoma is a major cause of adrenergic overactivity, leading to transient myocardial dysfunction through excessive catecholamine release. Endocrine disorders, including thyroid storm and severe hypoglycemia, also contribute to hyperadrenergic states. Additionally, abrupt withdrawal of adrenergic-blocking medications can induce rebound hypertension and cardiac dysfunction. The pathophysiology of TCM in these conditions involves catecholamine-mediated myocardial stunning, endothelial dysfunction, and autonomic imbalance. Management requires targeted pharmacological therapy, hemodynamic stabilization, and addressing the underlying etiology. Recognizing hyperadrenergic crisis as a potential cause of TCM is crucial for early intervention. Timely diagnosis, appropriate pharmacologic management, and treating the primary condition can prevent severe cardiovascular outcomes.