Pheochromocytoma Crisis Presenting as Cardiac Arrest and Reversible Cardiomyopathy in a Young Adult: A Case Report

Acute circulatory collapse and severe myocardial dysfunction in young adults without prior cardiovascular disease represent a critical diagnostic challenge in emergency and intensive care settings. We report the case of a 32-year-old man who presented to the emergency department with acute respiratory failure, profound metabolic acidosis, and hemodynamic instability, rapidly progressing to cardiac arrest with the return of spontaneous circulation. Initial evaluation revealed severe biventricular dysfunction and markedly elevated cardiac biomarkers. CT identified a large right adrenal mass suggestive of pheochromocytoma. Biochemical testing later confirmed markedly elevated plasma and urinary catecholamines and metanephrines. The patient required invasive mechanical ventilation, vasoactive support, and advanced intensive care management. Progressive recovery of myocardial function was observed following stabilization and targeted medical therapy, supporting the diagnosis of catecholamine-induced cardiomyopathy. He was subsequently referred for endocrine follow-up and definitive surgical management. This case highlights pheochromocytoma crisis as a rare but reversible cause of cardiac arrest and acute cardiomyopathy in young adults. Early recognition and coordinated intensive care and endocrine management are crucial to improve outcomes in this potentially fatal condition.