[Cardiogenic shock after adrenalectomy for pheochromocytoma]

A 56 year old patient underwent left-sided adrenalectomy for a benign pheochromocytoma. During surgery, he developed a hypertensive crisis while the tumor was being manipulated. Postoperatively, the patient became hypotensive and developed cardiogenic shock. He remained ventilated and intubated. In the subsequent echocardiography a severely impaired left ventricular function with apical akinesia was observed, while the preoperative echocardiogram was normal. Acute coronary angiography was performed which showed no significant stenoses in the coronary arteries. Apical ballooning was seen in the left ventricular angiogram. On the second postoperative day, echocardiography showed an improved left ventricular function which was almost normalized within the next week. Catecholamine release during a left-sided adrenalectomy for a benign pheochromocytoma was associated with Takotsubo cardiomyopathy complicated by cardiogenic shock.