UNUSUAL CARDIAC MANIFESTATIONS AS THE PRE SENTATION OF PHEOCHROMOCYTOMA - BASED UPON 3 CASES

The diagnosis of pheochromocytoma is usually considered in the presenc e of permanent hypertension with exacerbations. However, pheochromocyt oma may be responsible for a varied range of adrenergic symptomatology and hemodynamic equilibrium may be threatened by the spontaneous or i nduced massive release of pressor amines. Three cases form the basis o f a description of unusual situations: acute pulmonary edema, acute ci rculatory failure and myocardial infarction with normal coronary vesse ls. The divercity and severity of these clinical situations are such t hat the possibility should always be suspected when confronted by any cardiomyopathy without obvious etiology, in particular in a hypertensi ve patient. The only treatment remains ablation of the tumour and diag nosis as an emergency is based, apart from history, on ultrasonography and/or abdominal CT scan and assay of urinary catecholamine derivativ e levels, which can be obtained within a few hours.