Cardiogenic shock due to pheochromocytoma-induced catecholamine crisis in a young woman

A pheochromocytoma is a rare catecholamine-secreting tumor that can cause life-threatening complications. Circulatory shock with a significant cardiogenic component is an uncommon initial presentation. This case describes a previously healthy 30-year-old woman presenting with vomiting, hyperglycemia, and shock. This rapidly progressed to requiring intubation, vasopressor therapy, and resuscitation following cardiac arrest. Imaging revealed a right adrenal mass and plasma metanephrines and normetanephrines were markedly elevated. After stabilization with α- and β-adrenergic blockade, the patient underwent successful adrenalectomy, confirming a pheochromocytoma-induced catecholamine crisis, with full recovery of cardiac function. This case illustrates the diversity of initial presentation of pheochromocytoma, the diagnostic challenges associated with measuring plasma (nor)metanephrines after resuscitation and the reversible nature of catecholamine-induced cardiomyopathy.