Pheochromocytoma crisis is a medical emergency. The raised catecholamine levels are toxic to the myocardium, resulting in impaired left ventricular systolic function. Extracorporeal membrane oxygenation (ECMO) may be necessary for life support.


(1) unexplained cardiogenic shock with multi-organ dysfunction

(2) variable malignant hypertension

(3) adrenal mass on abdominal CT or ultrasound

(4) elevated urinary metanephrine and catecholamine concentrations


Indications for ECMO, typically venoarterial:

(1) refractory cardiac arrest

(2) cardiogenic shock


Adrenalectomy is often required to remove the source of the catecholamines. Urgent surgery may be necessary for hemorrhagic pheochromocytoma or unstable crisis.

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