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Pheochromocytoma-Induced Takotsubo Syndrome Treated with Extracorporeal Membrane Oxygenation: Beware of the Apical Sparing Pattern (JACC: Case Reports August 2019)
A 45-year-old female presents with suspected acute myocardial infarction with cardiogenic shock requiring mechanical circulatory support. Pheochromocytoma-induced atypical Takotsubo syndrome is diagnosed. Clinicians should suspect high catecholamine states as a cause of the basal subtype of atypical Takotsubo syndrome. (Level of Difficulty: Beginner.) (J Am Coll Cardiol Case Rep 2019;1:85–90) © 2019 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://


Julia Grapsa, MD, PhD, FACC

Omid Kiamanesh, MD

Graham C. Wong, MD, MPH

CME Information

Target Audience

JACC Journal CME/MOC/ECME is intended for physicians who treat patients with cardiovascular disease.

Important Dates

Date of Release: August 12, 2019
Term of Approval/Date of CME/MOC/ECME Expiration: August 11, 2020

Learner Objectives

Upon completion of this activity, the reader will be able to:

  • Describe the classification of takotsubo syndrome.
  • Discuss common triggers of takotsubo syndrome.
  • Differentiate takotsubo syndrome from common mimicking diagnoses.
  • Describe long-term outcomes of patients with takotsubo syndrome.

Method of Participation and Claiming Credit
This ACC JACC Journals CME/MOC/ECME activity includes the reading of an article published in one of the JACC journals and the successful completion of self-assessment questions.  

Requesting AMA PRA Category 1 CME Credit™ and/or MOC, or ECME credit for this Activity
To request credit, you must:

  1. Read the article for which you wish to receive credit.
  2. Answer the self-assessment questions. You need to have achieved a passing score of 70% or better in order for the Evaluation link to become activated. If you did not achieve a passing score, please click on the Posttest link in the left navigation bar and retake the exam.
  3. After you complete the Evaluation, click on the Claim Credit button in the left navigation bar.
  4. For CME credit, enter the total amount of time you actually spent in the activity in the box provided. Please note that you may only claim once for this activity. Click Claim.
  5. For MOC credit, click the Claim button in the row for MOC. Please note that you may only claim once for this activity. Confirm your ABIM number and date of birth.
  6. For ECME credit, click the Claim button in the row for EMCE. Please note that you may only claim once for this activity. Enter date of birth and click Submit.
  7. The page will be updated with the date and time that you claimed your credit.
  8. To view your credit, or to print a certificate, please go to and navigate to the My Transcript section of My ACC.

This CME/MOC/ECME-certified activity may contain links to other educational resources such as clinical trial summaries, journal articles, guidelines, etc., that may not be CME/MOC/ECME certified. Please note that clicking on the links provided to view these resources will open new windows, which are outside of this CME/MOC/ECME-certified activity.

Availability: On-Demand
Cost: FREE
Credit Offered: 1 CME Credit
1 ECME Credit
1 MOC Credit
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