REVERSAL OF SEVERE CARDIAC SYSTOLIC DYSFUNCTION CAUSED BY PHEOCHROMOCYTOMA IN A HEART-TRANSPLANT CANDIDATE

Whenever a patient is evaluated as a possible candidate for heart tran splantation, potential causes of reversible cardiomyopathy must always be considered. Although rare, it is well-known that pheochromocytoma can result in a dilated cardiomyopathy, which can be partially or comp letely reversible. We report a case of a 33-year-old woman with heart failure that was caused by a severe dilated cardiomyopathy who was ref erred for urgent heart transplant evaluation. The diagnosis of bilater al adrenal pheochromocytomas was made, and within 3 weeks of medical t herapy, left ventricular systolic dysfunction completely reversed, avo iding the need for heart transplantation. The patient later underwent successful adrenalectomy. Unique features of this case of pheochromocy toma-induced cardiomyopathy include (1) serial norepinephine measureme nts over 3 weeks documenting the efficacy of medical therapy, (2) uniq ue cutaneous manifestations that resolved with medical therapy, and (3 ) familial multiple endocrine neoplasia syndrome with medullary carcin oma of the thyroid in three generations of this patient's family.