A 45-year-old male presented with acute pulmonary oedema, chest pain and electrocardiographic manifestations of acute myocardial ischaemia in the setting of hypertension crisis from a hyperfunctioning large left-sided pheochromocytoma. Coronary artery disease was excluded on the basis of thallium stress testing and coronary angiography. The latter revealed a picture consistent with dilated cardiomyopathy. After surgical resection of the tumour, both the hypercatecholaminaemia and the arterial hypertension subsided promptly with gradual improvement of the cardiomyopathy and complete resolution of the congestive heart failure symptoms.