Catecholamine Cardiomyopathy

To the Editor: The recent case report by Imperato-McGinley et al. (March 26 issue) 1 makes a valuable contribution to the care of patients with pheochromocytoma-related myocardial disease. The authors refer to the acutely induced changes of cathecholamine cardiotoxicity as "myocarditis." Although many workers have used this term, it is inappropriate. Catecholamines induce focal myocardial necrosis. The inflammatory reaction, or "myocarditis," is secondary to the necrosis. 2 The necrosis is apparently due to a direct effect of catecholamines on calcium influx into cardiac myocytes. 3 , 4 It is important to identify this condition as myocardial necrosis because this indicates the primary pathologic process and . . . No extract is available for articles shorter than 400 words.