Before admission	Short-lasting episodes of palpitations
27 July 2019 (Day 1)	Admission to the emergency department (ED): hypertensive crisis (230/110 mmHg) complicated by pulmonary oedema, type II myocardial infarction with low left ventricular ejection fraction (LVEF) and diffuse akinesia, metabolic acidosis Intubation and transfer to a II level ED Implant of venoarterial extracorporeal membrane oxygenation (VA ECMO) and IMPELLA due to cardiogenic shock Diagnosis of Takotsubo cardiomyopathy Admission to the cardiothoracic intensive care unit
28 July 2019 (Day 2)	Acute kidney injury requiring renal replacement therapy (RRT)
29 July 2019 (Day 3)	Right hemiplegia Total body computed tomography: bilateral parieto-occipital ischaemic areas; hypodense subcortical area in the left frontal lobe; 5 cm tumour of the left adrenal gland (pheochromocytoma)
30 July 2019 (Day 4)	VA ECMO removal Episodes of hypertensive crisis treated with alpha lityc agents (urapidil) and beta blockers
31 July 2019 (Day 5)	IMPELLA removal
1 August 2019 (Day 6)	Diagnosis of pheochromocytoma confirmed by high levels of plasmatic catecholamines and endomyocardial biopsies suggesting catecholamine-induced cardiomyopathy
2 August 2019 (Day 7)	Magnetic resonance imaging confirming posterior reversible encephalopathy syndrome diagnosis
5 August 2019 (Day 10)	Transfer to the Department of Shock and Trauma Blood pressure control through alpha lityc agents (including dexmedetomidine and doxazosin at maximum daily dose) and beta blockers
13 August 2019 (Day 18)	Left videolaparoscopic adrenalectomy Discontinuation of doxazosin treatment and RRT
14 August 2019 (Day 19)	Extubation
22 August 2019 (Day 27)	Discharge from the Department of Shock and Trauma with no residual neurological deficit
25 August 2019 (Day 30)	Discharge from hospital. Complete recovery of LVEF