Pheochromocytoma as a Cause of Decompensated Dilated Cardiomyopathy: A Rare Case Report

Abstract

Introduction: Pheochromocytoma is a neuroendocrine tumour derived from chromaffin cells that produce catecholamines. The classical clinical triad is characterised by headaches, palpitations and sweating. Our patient presented initially with severe dilated cardiomyopathy and acute decompensated heart failure, which necessitated optimisation prior to surgical removal of the adrenal glands. Case Presentation: A 57-year-old female patient was admitted to the hospital with symptoms of dyspnoea, oedema of the lower extremities, and atrial fibrillation. Echocardiography demonstrated a dilated left ventricle with global hypokinesia and a left ventricular ejection fraction of 10%. The patient was treated for acute systolic heart failure decompensation with diuresis and afterload reduction. Unexpectedly, an abdominal CT scan revealed bilateral adrenal mass, and subsequent serum/urinary metanephrine tests indicated the presence of pheochromocytoma. Conclusion: In conclusion, the presence of acute congestive heart failure resulting from the development of dilated cardiomyopathy, the aetiology of which remains uncertain, should prompt consideration of the potential existence of a pheochromocytoma. It is important to note that pheochromocytomas do not always manifest in accordance with the established triad of symptoms, which includes headache, palpitations and diaphoresis. Furthermore, catecholamines have been demonstrated to induce cardiomyopathy and, subsequently, to progress to congestive heart failure.