From trivial headache to life-threatening disease

Abstract Sometimes, a clinical course that initially appears to be ‘classic' turns out to be a manifestation of a rare disease. We report on a 62-year-old woman who presented initially with episodic headache, followed by cardiogenic shock. What was first thought to be an ST-segment elevation acute myocardial infarction, later to be a takostubo cardiomyopathy, finally appeared to be a catecholamine-induced cardiomyopathy due to a pheochromocytoma. This case illustrates that in a patient with presumed takotsubo cardiomyopathy and episodic headache, sweating, hypertension or tachycardia, pheochromocytoma needs to be excluded.