title: Unexpected triggers for pheochromocytoma-induced recurrent heart failure.
abstract: Pheochromocytoma crisis typically presents as paroxysmal episodes of headache, tachycardia, diaphoresis or hypertension. We describe an uncommon case of recurrent non-hypertensive heart failure with systolic dysfunction in a young female due to pheochromocytoma compression. It presented as acute pulmonary oedema while straining during pregnancy and later on as cardiogenic shock after a recreational body massage. Such crisis occurring during pregnancy is rare. Moreover, of the few reported cases of pheochromocytoma-induced cardiogenic shock, recreational body massage has not yet been reported as a trigger for this condition.
authors.affiliation: Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
authors.forename: Tiago
authors.initials: T
authors.lastname: Pereira-da-Silva
authors.affiliation: Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Abreu
authors.affiliation: Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
authors.forename: Ruben
authors.initials: R
authors.lastname: Ramos
authors.affiliation: Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Galrinho
authors.affiliation: Emergency and Intensive Care Department, Hospital de São José, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
authors.forename: Philip
authors.initials: P
authors.lastname: Fortuna
authors.affiliation: MRI Center of Caselas, Lisbon, Portugal.
authors.forename: Nuno Jalles
authors.initials: NJ
authors.lastname: Tavares
authors.affiliation: Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
authors.forename: Rui Cruz
authors.initials: RC
authors.lastname: Ferreira
keywords: Body massage; Cardiogenic shock; Heart failure; Pheochromocytoma; Pregnancy