Pheochromocytoma without hypertension presenting as cardiomyopathy

Abstract

Characteristically, a patient with pheochromocytoma presents with paroxysmal or sustained hypertension and related symptoms. Occasionally the predominant manifestation of such a tumor may be congestive heart failure associated with primary myocardial disease, and hypertension may be absent. A patient with pheochromocytoma whose symptoms and clinical course related to a primary cardiomyopathy, and who remained normotensive until the final month of illness, has been presented. Mechanisms implicated in the development of primary myocardial disease by a pheochromocytoma have been reviewed. Diagnostic and therapeutic measures have been briefly outlined. The physician must be alert to the relatively rare occurrence of a pheochromocytoma in a patient who presents with a primary cardiomyopathy or unexplained congestive heart failure, since removal of the tumor allows for regression, if not cure, of the associated heart disease.