Fatal acute heart failure secondary to pheochromocytoma: A sudden death case report

A 36 years old female, was investigated for “pregnancy induced hypertension” during her pregnancy. The hypertension “resolved” during the second and third trimester of the pregnancy. She delivered a healthy baby girl and the delivery was uneventful. Her recent admission was due to palpitations, frontal headaches, feeling of nausea with vomiting and epigastric tenderness. She had tachycardia (110/min) and high blood pressure (158/110 mmHg) with cold and clammy hands. ECG showed sinus tachycardia and ST depression (Junctional). Other examination was unremarkable. She was treated with beta blocker. She deteriorated with hypotensive episodes and ECG changes of 2:1 AV block. She succumbed to her illness and was pronounced dead on the second day of the admission. Postmortem examination revealed the presence of pheochromocytoma, in the right adrenal gland and scattered small foci of myocardial necrosis despite patent coronary vessels. The cause of death was given as acute heart failure secondary to pheochromocytoma. The clinica-pathological aspect of pheochromocytoma in this case is discussed.