Improvement of young-onset dilated cardiomyopathy by successful resection of pheochromocytoma

Pheochromocytoma-induced cardiomyopathy is a rare but serious condition caused by excessive catecholamine release, leading to heart failure and life-threatening hemodynamic instability. Managing such cases requires a delicate balance of treatments to stabilize the cardiovascular system while preparing for tumor removal. A 16-year-old boy came to the hospital with severe abdominal pain, palpitations, and breathlessness, which progressively worsened despite multiple medical consultations. He was diagnosed with dilated cardiomyopathy and severe heart failure and was worked up extensively for the same. He was planned for heart transplantation after stabilization. However, a non-contrast computed tomography of the abdomen done as part of the pre-operative workup showed an adrenal lesion, and further testing revealed an adrenal pheochromocytoma. His treatment required careful adjustments of medications to support his heart while ensuring safe tumor resection. Alpha-blockers, inotropes, and fluid management were carefully balanced to prevent complications. A highly coordinated team of endocrinologists, cardiologists, anesthesiologists, and surgeons worked together to optimize his condition before surgery. He underwent a successful open adrenalectomy, and with intensive postoperative care, his left ventricular function gradually improved. A year later, he remains symptom-free, with his catecholamine levels returning to normal and ejection fraction improving from 10% to 40%. This case underscores the importance of personalized care and a multidisciplinary approach in managing pheochromocytoma-related heart failure, ensuring both surgical success and long-term recovery.