Catecholamine-Induced Cardiomyopathy Initially Misdiagnosed as Myocarditis in a Patient With Pheochromocytoma

Catecholamine-induced cardiomyopathy (CICMP) is myocardial injury from excessive catecholamine secretion by pheochromocytoma/paraganglioma (PPGL), with reversible cardiac dysfunction post-tumor resection.

A 29-year-old female initially hospitalized for severe myocarditis recovered but presented 3 years later with marked blood pressure fluctuations. She was diagnosed with CICMP secondary to pheochromocytoma and managed with aggressive blood pressure control and successful tumor resection, achieving favorable outcomes with stable blood pressure off medications.

Literature review shows CICMP is occult. The reminder for clinicians from this case is that for atypical myocarditis, especially in patients experiencing blood pressure fluctuations, PPGL should be considered, and relevant examinations should be promptly completed.

Blood pressure lability in a young patient with suspected myocarditis should immediately raise suspicion for PPGL and prompt biochemical screening.