Case Report : Pheochromocytoma - related catecholamine cardiomyopathy with successful outcomes after orthotopic heart transplantation

Pheochromocytomas (rare catecholamine-producing neuroendocrine tumors) have many different manifestations, and complications can occasionally include myocardial infarction and cardiomyopathy. In a majority of cases, cardiomyopathy reverses following medical or surgical treatment of the pheochromocytoma. We report a case of a 28-year-old male patient with preoperative diagnosis of pheochromocytoma and for whom a successful adrenalectomy revealed a benign pheochromocytoma. The patient had decompensation of heart failure and subsequent needed heart transplantation for irreversible cardiomyopathy; this gave a good outcome three years post-transplant. The heavy burden of atherosclerosis and fibrosis in a young patient with few cardiac risk factors and the irreversible cardiac damage are unique features of this case. This is also the first report (to our knowledge) of a patient with a pheochromocytoma that was surgically resected but who subsequently needed cardiac transplantation. We conclude that catecholamine-induced cardiomyopathy may be irreversible if there is structural damage to myocytes despite adequate medical and surgical treatment of a pheochromocytoma. 1 2 3 4