A case of pheochromocytoma diagnosed after the onset of severe heart failure in the third trimester of pregnancy：A case report

Abstract

We experienced anesthesia for an emergency caesarean section at 34 weeks’ gestation with a sudden drop in SpO₂ with orthopnoea. Due to the difficulty of the supine position, we administered general anesthesia. Postoperative transthoracic echocardiography revealed a left ventricular ejection fraction of 30% and a diagnosis of severe heart failure due to peripartum cardiomyopathy. The patient required temporary left ventricular assist treatment with Impella^TM. However, a post-operative CT scan incidentally revealed a pheochromocytoma, and after medical treatment, a laparoscopic adrenalectomy was performed. In cases of perinatal hypocontractility and cardiac failure, anesthetists should consider the possibility of pheochromocytoma in patient assessment and anesthetic management.