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TALK WITH YOUR DOCTOR IF YOU:

• Experience a sudden, severe increase in blood pressure (hypertensive crisis)
• Have difficulty controlling high blood pressure
• Are taking more than four medications for high blood pressure
• Experience the other signs and symptoms relating to a pheochromocytoma (listed in the tables below)
• Have a family history of pheochromocytoma or genetic mutation that may include multiple endocrine neoplasia, type II (MEN II); von Hippel-Lindau disease; neurofibromatosis 1 (NF1); mutations in the SDHx gene (SDHA, SDHB, SDHC, SDHD)

The tables below list several signs and symptoms of pheochromocytoma and the frequency with which they are seen in pheochromocytoma patients.

Preoperative management of the Pheochromocytoma Patient. Pacak, K. JCEM 2007; 92:4069.

Symptoms may occur in episodes or paroxysms. These may be variable but typically include palpitation, tremor, diaphoresis, and headache. Attacks may start as a feeling of shortness of breath followed by chest pain and headache. Coldness in the hands and feet and facial pallor may occur. Spells may occur multiple times daily or as infrequently as once monthly. The typical duration of a pheochromocytoma spell is 15 to 20 minutes, but it may be much shorter or last several hours.

Additional clinical signs of pheochromocytoma include hypertensive retinopathy, orthostatic hypotension, angina, nausea, constipation, hyperglycemia, diabetes mellitus, hypercalcemia, and mass effects from the tumor.