Catecholamine cardiomyopathy in bilateral malignant pheochromocytoma: successful reversal after surgery

Abstract

We report a case of a 22-year-old female presenting episodes of headache, palpitation and abdominal pain for 2 months, with a past history of episodes of cough, orthopnoea and pedal edema. She was cachectic, pale, hypertensive (HT) and in congestive cardiac failure (CCF), with loud A2, palpable and audible LV S3 and mild MR and TR. A lump was palpable in the right lumbar region, and there were no features suggestive of other component of multiple endocrine neoplasia. All laboratory findings were normal, except hemoglobin 6 gm/dl and raised 24-h urinary metanephrines excretion (45 times of normal limits). Abdominal sonogram and CT detected bilateral adrenal masses and retroperitoneal lymphadenopathy.