Spontaneous adrenal haemorrhage after catheter ablation of supraventricular tachycardia

Catheter ablation is established as a first-line therapy for most patients with recurrent supraventricular tachycardia (SVT), with high success rates and very low complication rates. A 60-year-old woman developed severe right flank pain following straightforward catheter ablation for SVT. This was caused by a spontaneous right adrenal haemorrhage, which, after much delay, was eventually recognised as the cause of her symptoms. Adrenal haematomas are rare and, to the best of our knowledge, this is the first reported case of spontaneous adrenal haemorrhage occurring after any interventional cardiac procedure. Clinicians should be aware of this rare but potentially serious complication and consider it as a differential diagnosis in any patient with severe flank pain following interventional cardiac procedures, to prevent delays in diagnosis.