Introduction
Pheochromocytoma related cardiomyopathy could be lead to a refractory CS for that a rescue procedure with an Extracorporeal Life Support (ECLS) application, such as ECMO, to sustain the circulation and the organ perfusion giving time to the myocardium for complete recovery, is mandatory. A few cases of patients suffering from pheochromocytoma-induced CS requiring MCS have been previously reported in literature [1], but no case approached with a combined use of ECMO and Impella (for LV unloading). We describe the first successful treatment of a pheochromocytoma-induced CS with the combined use of peripheral V-A ECMO and IMPELLA CP, with subsequent complete and fast recovery of the myocardial function.