CARDIAC-FAILURE DUE TO CARDIOMYOPATHY AS THE PRESENTATION OF A PHEOCHROMOCYTOMA - PERIOPERATIVE MANAGEMENT

A case of cardiomyopathy secondary to an unrecognised pheochromocytoma is reported. It was cured by successful outset with congestive cardiac failure with an ejection fraction of 11%. Following medical treatment including a beta-blocker and converting enzyme inhibitors, the situation remained so disturbing that cardiac transplant was envisaged. It was nevertheless decided to first remove the tumour, with mechanical circulatory assistance cover if necessary. Surgical excision proved to be relatively easy. Cardiac failure disappeared clinically within a few days, though a degree of myocardial impairment revealed by paraclinical investigations persisted after ten months. The pathophysiology, beneficial effect of beta-blockers and the SvO(2), usefulness blood during the perioperative period are discussed. The prognosis of the cardiomyopathy, considered up to the present to be uncertain, new seems favourable once it is possible to completely excise the tumour.