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Published Online:https://doi.org/10.1176/ajp.113.4.295

1. A case of pheochromocytoma is reported with a fatal cardiac arrest following electroconvlusive therapy. The diagnosis was particularly difficult as no paroxysm of hypertension was ever detected. In addition, there was no sustained hypertension to arouse suspicion. Although a little atypical the patient's signs and symptoms suggested a tension depression.

2. It is certain that pheochromocytoma is an absolute contraindication to electroconvulsive therapy. The authors could find no previous report in the literature on this matter.

3. This case is presented primarily so that other psychiatrists may become more aware of a tumor which can produce symptoms distressingly similar to those found in various anxiety states with or without depression.

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