{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:12:09Z","timestamp":1790619129986,"version":"4.1.0"},"reference-count":30,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,2,17]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>We report a case of a woman in her mid-30s who developed severe cardiac shock hours after giving birth to her second child with the need for extracorporeal haemodynamic support. Initially, postpartum cardiomyopathy was suspected, and high-urgency heart transplantation was considered. However, the endocrine work-up and imaging revealed pheochromocytoma as the cause for acute heart failure that was completely reversible. Notably, the patient also developed Sheehan\u2019s syndrome with pituitary necrosis and sustained hypopituitarism, most likely as a consequence of the haemodynamic failure during pheochromocytoma crisis. While pheochromocytoma crisis is already an extremely rare peripartum complication, the current case is\u2014to the best of our knowledge\u2014the first report of pheochromocytoma associated with Sheehan\u2019s syndrome. This case also highlights the clinical conundrum that pheochromocytomas can be easily overlooked in pregnancy due to non-specific symptoms and confusion with pregnancy-related hypertension or hypertension-associated other diseases. Appropriate case detection is important, especially in pregnant women with early onset of hypertension.<\/jats:p>","DOI":"10.1136\/bcr-2024-261704","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T16:23:19Z","timestamp":1742401399000},"page":"e261704","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Postpartum pheochromocytoma crisis associated with cardiogenic shock and Sheehan\u2019s syndrome"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0191-9750","authenticated-orcid":false,"given":"David","family":"Wall","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Nieding","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Scheuba","sequence":"additional","affiliation":[{"name":"Division of Visceral Surgery, Austria European Neuroendocrine Tumor Society (ENETS) Center of Excellence, Medical University of Vienna Department of General Surgery, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Haug","sequence":"additional","affiliation":[{"name":"Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Schmook","sequence":"additional","affiliation":[{"name":"Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2191-025X","authenticated-orcid":false,"given":"Florian W","family":"Kiefer","sequence":"additional","affiliation":[{"name":"Clinical Division of Endocrinology and Metabolism, Medical University of Vienna Department of Medicine III, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"2025082709103989000_18.3.e261704.1","first-page":"8","article-title":"Peripartum cardiomyopathy: a review","volume":"39","author":"Bhattacharyya","year":"2012","journal-title":"Tex Heart I J"},{"key":"2025082709103989000_18.3.e261704.2","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s00101-002-0442-2","article-title":"Peripartale Kardiomyopathie","volume":"52","author":"Martin","year":"2003","journal-title":"Anaesthesist"},{"key":"2025082709103989000_18.3.e261704.3","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.annfar.2008.11.001","article-title":"Myocardiopathie du p\u00e9ripartum : incidence, physiopathologie, manifestations cliniques, prise en charge th\u00e9rapeutique et pronostic","volume":"28","author":"Bahloul","year":"2009","journal-title":"Annales Fran\u00e7aises d\u2019Anesth\u00e9sie et de R\u00e9animation"},{"key":"2025082709103989000_18.3.e261704.4","first-page":"195","article-title":"Cardiorespiratory crisis at the end of pregnancy: a case of pheochromocytoma","volume":"22","author":"Haddad","year":"2013","journal-title":"Middle East J Anaesthesiol"},{"key":"2025082709103989000_18.3.e261704.5","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1007\/s10741-024-10435-5","article-title":"Peripartum cardiomyopathy: a comprehensive and contemporary review","volume":"29","author":"Sigauke","year":"2024","journal-title":"Heart Fail Rev"},{"key":"2025082709103989000_18.3.e261704.6","doi-asserted-by":"crossref","DOI":"10.2174\/1573403X18666220823151854","article-title":"Review of Randomized Controlled Trials in Patients with Peripartum Cardiomyopathy","volume":"19","author":"Mujkanovic","year":"2023","journal-title":"Curr Cardiol Rev"},{"key":"2025082709103989000_18.3.e261704.7","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/S2213-8587(20)30371-5","article-title":"Phaeochromocytoma and pregnancy: looking towards better outcomes, less fear, and valuable recommendations","volume":"9","author":"Pacak","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025082709103989000_18.3.e261704.8","doi-asserted-by":"crossref","unstructured":"Maru\u0161i\u0107 R , Oluji\u0107 M , Ba\u010dun T . 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