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 cardia c failure with an ejection fraction of 11%. Following medical treatmen t including a beta-blocker and converting enzyme inhibitors, the situa tion remained so disturbing that cardiac transplant was envisaged. It was nevertheless decided to first remove the tumour, with mechanical c irculatory assistance cover if necessary. Surgical excision proved to be relatively easy. Cardiac failure disappeared clinically within a fe w days, though a degree of myocardial impairment revealed by paraclini cal investigations persisted after ten months. The pathophysiology, be neficial effect of beta-blockers and the SvO(2), usefulness blood duri ng the perioperative period are discussed. The prognosis of the cardio myopathy, considered up to the present to be uncertain, new seems favo urable once it is possible to completely excise the tumour.