Pheochromocytoma is a relatively rare catecholamine-secreting tumor (0.1 to 0.8% of hypertensives). It has a large spectrum of clinical and biochemical manifestations. The clinical manifestation of acute myocarditis has only rarely been reported. We describe a case of a 46-year-old woman who presented with cardiogenic shock associated with acute pulmonary edema following an upper respiratory infection, which was initially presumed to be acute viral myocarditis. Cardiac function progressively improved after serial management including intra-aortic balloon pump and extracorporeal membrane oxygenation but soon deteriorated two days after weaning off the mechanical support. The episodic high blood pressure, tachycardia and marked fluctuation of cardiac function during hospitalization subsequently led to the correct diagnosis of pheochromocytoma.