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

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