title: [Pheochromocytoma and cardiogenic failure: an indication for emergency adrenalectomy].
abstract: OBJECTIVE
  To identify cardiogenic failure or cardiogenic shock associated with pheochromocytoma diagnosis and emergency adrenalectomy. Update this unusual presentation of pheochromocytoma.
  
  
  METHODS
  Between 1998 and 2009, 119 adrenalectomies were performed in our department, among which 19 cases for pheochromocytoma. We reported three cases with cardiogenic failure or cardiogenic shock associated with emergency adrenalectomy.
  
  
  RESULTS
  Patients were 36, 41 and 67 years old. The elapsed time between cardiogenic failure and surgery was 0, 7 and 19 days. The first diagnosis was a viral myocarditis in those three cases. The diagnosis of adrenal pheochromocytoma was done in a second step by the association of adrenal tumour on abdominal CT scan and detection of significantly elevated plasma/urine catecholamine. Severe systolic dysfunction with low ejection fraction was associated in all cases. Cardiac function was quickly restored after adrenalectomy.
  
  
  CONCLUSIONS
  Cardiac emergency associated with pheochromocytoma is an unusual clinical presentation. When diagnosis fails to be performed, patients have a very poor prognosis. According to a review of the sparse literature, only early recognition and emergency adrenalectomy can improve the outcome.
authors.affiliation: Service d'urologie-transplantation, université Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, Salouel, 80054 Amiens cedex 1, France.
authors.forename: J
authors.initials: J
authors.lastname: Vandwalle
authors.forename: R
authors.initials: R
authors.lastname: Spie
authors.forename: G
authors.initials: G
authors.lastname: Jarry
authors.forename: V
authors.initials: V
authors.lastname: Agaesse
authors.forename: J
authors.initials: J
authors.lastname: Petit
authors.forename: F
authors.initials: F
authors.lastname: Saint
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D004638:Emergency Treatment; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010673:Pheochromocytoma / Q000150:complications* / Q000601:surgery*; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000517:prevention & control*