Pheochromocytoma associated with apical-sparing left ventricular dysfunction due to acute afterload mismatch: a novel clinical entity?

The case of a patient with pheochromocytoma who presented with an unusual pattern of left ventricular dysfunction not previously described is reported. Although a triad of headaches, sweating attacks and palpitations is generally recognized as the classic mode of presentation of this pathology, this patient first presented with shock and pulmonary edema. Moreover, both echocardiography and angiography showed severe basal and mid-ventricular left ventricular dysfunction but preserved apical contractility. This hitherto unidentified finding was interpreted as being due to an afterload mismatch, rather than to an intrinsic myocardial injury, as is usually reported in such cases.