Pheochromocytoma-Induced Cardiomyopathy Requiring Mechanical Circulatory Support With Cardiac Recovery Following Surgical Resection.

BACKGROUND

Although exceedingly rare, pheochromocytomas can present with heart failure and cardiogenic shock, leading to complex management considerations.

CASE SUMMARY: A 49-year-old woman presented with chest pain and palpitations, and ultimately developed cardiogenic shock secondary to a pheochromocytoma. She required Impella 5.5 preceded by Impella CP (Abiomed) and venoarterial extracorporeal membrane oxygenation support as a bridge to surgical resection. After adrenalectomy, she was weaned from mechanical circulatory support, with recovery of left ventricular function.

DISCUSSION: Pheochromocytomas are rare catecholamine-secreting tumors. Patients typically present with episodic headache, sweating, and tachycardia; however, pheochromocytomas can be associated with cardiomyopathy secondary to the catecholamine excess. Mechanical circulatory support can serve as a safe and effective approach to stabilize patients while awaiting tumor resection.

TAKE-HOME MESSAGES: Mechanical circulatory support is a valuable adjunct in managing refractory heart failure by providing temporary hemodynamic stabilization while awaiting tumor resection. Ejection fraction can recover after removal of catecholamine-induced myocardial injury.