Two cases of acute coronary syndrome, the first revealing a pheochromocytoma and the second complicating its preoperative preparation for surgery are described. In both cases, a normal coronary angiography eliminated myocardial infarction. In the first case, an acute left ventricular dysfunction due to myocardial catecholamine toxicity was noted. The second patient had chest pain and syncope before and after a preoperative management using continuous IV administration of urapidil. Laparoscopic surgical resection of pheochromocytoma was uneventful in both cases.