Pheochromocytoma with uncommon ECG presentation

Pheochromocytoma is a rare neuroendocrine tumour with a highly variable clinical presentation. it may present with unusual presentation and these tend to mislead the physician into a delayed diagnosis. typical cardiac manifestations include st-segment deviations mimicking myocardial infarction,qt interval prolongation,blood pressure fluctuations,arrythmias mostly tachycardia but rarely may present with bradyarrythmia. we describe a case of pheochromocy-toma with rare findings of intermittent av dissociation associated with junctional and ventricular ectopic rhythm.