[Uncommon cardiac manifestations disclosing pheochromocytoma. Apropos of 3 cases]

The diagnosis of pheochromocytoma is usually considered in the presence of permanent hypertension with exacerbations. However, pheochromocytoma may be responsible for a varied range of adrenergic symptomatology and hemodynamic equilibrium may be threatened by the spontaneous or induced massive release of pressor amines. Three cases form the basis of a description of unusual situations: acute pulmonary edema, acute circulatory failure and myocardial infarction with normal coronary vessels. The divercity and severity of these clinical situations are such that the possibility should always be suspected when confronted by any cardiomyopathy without obvious etiology, in particular in a hypertensive patient. The only treatment remains ablation of the tumour and diagnosis as an emergency is based, apart from history, on ultrasonography and/or abdominal CT scan and assay of urinary catecholamine derivative levels, which can be obtained within a few hours.