Key result
Sequential VA-ECMO, medical therapy, and adrenalectomy successfully resolve cardiogenic shock in pheochromocytoma crisis.
Case Report (n=1)
Prompt diagnosis and mechanical circulatory support combined with targeted medical therapy can successfully manage pheochromocytoma-induced cardiogenic shock secondary to coronary vasospasm.
Case success with ECMO and blockade in pheochromocytoma shock; hypothesis-generating and should not yet change practice.
A 25-year-old woman presented with pheochromocytoma crisis and cardiogenic shock. Her ejection fraction was severely reduced at 10%, and she needed venoarterial extracorporeal membrane oxygenation (VA-ECMO) for hemodynamic support. Coronary angiography demonstrated diffuse coronary vasospasm as the underlying mechanism for her cardiogenic shock. Her ejection fraction improved with nondihydropyridine calcium channel blockers for treatment of epicardial coronary vasospasm. Her adrenal crisis was treated with sequential use of alpha-blockers followed by beta-blockers after resolution of cardiogenic shock; a right adrenalectomy was then performed before discharge. This case highlights the importance of prompt diagnosis and treatment of a pheochromocytoma complicated by cardiogenic shock when mechanical circulatory support is essential.
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Brilliant et al. (2025) conducted a case report in Pheochromocytoma crisis and cardiogenic shock (n=1). VA-ECMO and sequential medical/surgical therapy was evaluated. Sequential treatment with VA-ECMO, calcium channel blockers, alpha/beta-blockers, and adrenalectomy successfully managed a pheochromocytoma crisis complicated by cardiogenic shock.
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