Heart failure induced by a tumor in a young adult woman: A case report of dilated cardiomyopathy triggered by paraganglioma

Paragangliomas are rare neuroendocrine tumors that can secrete catecholamines, resulting in cardiovascular consequences such as catecholamine-induced cardiomyopathy and heart failure. The pathogenesis involves excessive catecholamine exposure, which causes myocardial damage, decreased cardiac function, and systemic consequences. We discuss the case of a 26-year-old adult woman who presented with dyspnea, orthopnea, and lower limb edema and was finally diagnosed with dilated cardiomyopathy. Echocardiography revealed an LVEF of 35%. Further investigation, including imaging and biochemical testing, revealed an abdominal paraganglioma compressing the renal arteries and markedly high plasma and urinary normetanephrine levels. A multidisciplinary team of cardiologists, endocrinologists, surgeons, and anesthesiologists worked together to enhance preoperative, intraoperative, and postoperative treatment. Preoperative alpha-blockade using phenoxybenzamine, followed by conservative beta-blockade, ensured hemodynamic stability. To avoid excessive catecholamine release, the tumor was carefully handled intraoperatively during surgical excision. The patient's clinical condition improved significantly after surgery, with catecholamine levels and heart function returning to normal.