Table of ContentsView AllTable of ContentsFrequent SymptomsUncommon or Rare SymptomsComplicationsWhen to See a Doctor
Table of ContentsView All
View All
Table of Contents
Frequent Symptoms
Uncommon or Rare Symptoms
Complications
When to See a Doctor
Pheochromocytomaproduces excess amounts of fight-or-flight hormones calledcatecholamines. These hormones can trigger symptoms such as high blood pressure, sweating, anxiety, palpitations, and headaches.
Pheochromocytoma symptoms often occur dramatically in episodes (paroxysms) that can happen a few times a week, or only once every few months. In adults, the symptoms may be similar to experiencing a panic attack (including a feeling of impending doom).
For children, symptoms can be feelings of anxiety or hyperactivity.
This article will review the symptoms associated with pheochromocytoma, potential complications, and when to see your healthcare provider.
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Pheochromocytoma symptoms are similar to many other conditions, but the combination of symptoms and the dramatic nature of how they occur can be a red flag and an indication of this condition.
The most common symptoms overall include:
In one study, almost 80% of people with pheochromcytoma had high blood pressure, and 53% had the classic triad of high blood pressure, sweating, and headaches.
When to Seek Emergency Medical CareBlood pressure spikes related to a pheochromocytoma are often severe and alarming. It’s important to note that severely elevated blood pressure can lead to immediate complications. And 1 in 14 people with a pheochromocytoma present or are first diagnosed when they have a heart attack.In the past, the term “malignant hypertension” was used to describe this extreme elevation. It is now usually referred to as ahypertensive crisis. A hypertensive crisis is defined as:A systolic blood pressure (top number) greater than 180 millimeters of mercury (mm Hg)A diastolic blood pressure (bottom number) greater than 120 mm HgEvidence of end-organ damage, meaning that the high blood pressure is causing secondary problems, such as damage to the retina of the eye and more
When to Seek Emergency Medical Care
Blood pressure spikes related to a pheochromocytoma are often severe and alarming. It’s important to note that severely elevated blood pressure can lead to immediate complications. And 1 in 14 people with a pheochromocytoma present or are first diagnosed when they have a heart attack.In the past, the term “malignant hypertension” was used to describe this extreme elevation. It is now usually referred to as ahypertensive crisis. A hypertensive crisis is defined as:A systolic blood pressure (top number) greater than 180 millimeters of mercury (mm Hg)A diastolic blood pressure (bottom number) greater than 120 mm HgEvidence of end-organ damage, meaning that the high blood pressure is causing secondary problems, such as damage to the retina of the eye and more
Blood pressure spikes related to a pheochromocytoma are often severe and alarming. It’s important to note that severely elevated blood pressure can lead to immediate complications. And 1 in 14 people with a pheochromocytoma present or are first diagnosed when they have a heart attack.
In the past, the term “malignant hypertension” was used to describe this extreme elevation. It is now usually referred to as ahypertensive crisis. A hypertensive crisis is defined as:
Other common symptoms include:
Some Tumors Are AsymptomaticEarly on, a pheochromocytoma may have no symptoms. These tumors are usually discovered incidentally, that is, when an imaging test of the abdomen, such as a CT (computed tomography) or MRI (magnetic resonance imaging) scan, is done for an unrelated condition.In one study, 61% of the tumors were detected “accidentally” on imaging studies, and another 4% were found when screening was done due to a genetic syndrome.
Some Tumors Are Asymptomatic
Early on, a pheochromocytoma may have no symptoms. These tumors are usually discovered incidentally, that is, when an imaging test of the abdomen, such as a CT (computed tomography) or MRI (magnetic resonance imaging) scan, is done for an unrelated condition.In one study, 61% of the tumors were detected “accidentally” on imaging studies, and another 4% were found when screening was done due to a genetic syndrome.
Early on, a pheochromocytoma may have no symptoms. These tumors are usually discovered incidentally, that is, when an imaging test of the abdomen, such as a CT (computed tomography) or MRI (magnetic resonance imaging) scan, is done for an unrelated condition.
In one study, 61% of the tumors were detected “accidentally” on imaging studies, and another 4% were found when screening was done due to a genetic syndrome.
Recognizing a Paroxysm or Episodic Crisis
A unique feature of pheochromocytoma for around 60% of people is the occurrence of crises, or paroxysms.Between these episodes, people may have no symptoms or only high blood pressure.
During these paroxysms, the tumor secretes larger amounts of catecholamines, leading to fairly classic symptoms, including rapid heart rate, sweating, anxiety and a sense of impending doom—often similar to what you might experience if you are suddenly very frightened.
Episodes may occur frequently, or instead, may only be seen once every few months. When present, the paroxysms may last only a few minutes, or they can instead last for hours. Over time, both the frequency of episodes as well as their duration and severity tend to increase.
Uncommon factors leading to a crisis include:
In general, emotional stress does not cause a crisis.
Uncommon symptoms may occur when a pheochromocytoma secretes hormones other than epinephrine or norepinephrine (the hormones responsible for the fight-or-flight response), with the symptoms related to the proteins or hormones that are secreted.
Some of these can include:
Complications can occur due to both the chronic and acute release of catecholamines into the bloodstream from the tumor and may affect any organ system.
Heart complications are most common, affecting up to one-third of people with pheochromocytoma.These complications may include:
Of note, a pheochromocytoma may cause heart damage even if it does not trigger any symptoms. The release of catecholamines from the tumor can also affect the brain and other organs, increasing the risk of stroke, neurological symptoms such as confusion and seizures, and kidney failure.
If a pheochromocytoma remains undiagnosed, the effects can damage many organs, leading to multiorgan failure.
Summary
The most common symptom of a pheochromocytoma is high blood pressure. High blood pressure may be chronic (ongoing) or occur in episodes called paroxysms. Other symptoms may include heart palpitations, headaches, sweating, anxiety, and a general sense of impending doom.
A Word From Verywell
The signs and symptoms of a pheochromocytoma overlap with many conditions, but often stand out due to their severity, as well as their tendency to occur in episodes, or paroxysms. While high blood pressure is very common, if it occurs along with palpitations, headaches, sweating, tremors, anxiety, and a feeling of impending doom, it’s important to talk to your healthcare provider.
Fortunately, either blood or urine testing can usually rule out or confirm a diagnosis of pheochromocytoma, even in those who have a hereditary syndrome associated with the disease.
The potential complications of a pheochromocytoma are also anxiety provoking, but many of these can be avoided with prompt evaluation and treatment of any symptoms you have.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.Pheochromocytoma and paraganglioma treatment (PDQ)-health professional version.Falhammar H, Kjellman M, Calissendorff J.Initial clinical presentation and spectrum of pheochromocytoma: a study of 94 cases from a single center.Endocrine Connect.2018;7(1):186-192. doi:10.1530/EC-17-0321Uslar T, SanFrancisco IF, Olmos R, et al.Clinical presentation and perioperative management of pheochromocytomas and paragangliomas: a 4-decade experience.J Endocr Soc. 2021;22;5(10):bvab073. doi:10.1210/jendso/bvab073Zhou J, Xuan H, Miao Y, Hu J, Dai Y.Acute cardiac complications and subclinical myocardial injuries associated with pheochromocytoma and paraganglioma.BMC Cardiovasc Disord.2021;21(1):203. doi:10.1186/s12872-021-02013-6Y-Hassan S, Falhammar H.Cardiovascular Manifestations and Complications of Pheochromocytomas and Paragangliomas.J Clin Med.2020;9(8):2435. doi:10.3390/jcm9082435Jameson JL, De Groot LJ, de Kretser DM, et al, eds.Endocrinology: Adult and Pediatric.7th ed. Philadelphia, PA: Elsevier Saunders; 2016Y-Hassan S, Falhammar H.Cardiovascular Manifestations and Complications of Pheochromocytomas and Paragangliomas.J Clin Med.2020;9(8):2435. doi:10.3390/jcm9082435Y-Hassan S, Falhammar J.Pheochromocytoma- and paraganglioma-triggered Takotsubo syndrome.Endocrine. 2019;65(3):483-493. doi:10.1007/s12020-019-02035-3
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.Pheochromocytoma and paraganglioma treatment (PDQ)-health professional version.Falhammar H, Kjellman M, Calissendorff J.Initial clinical presentation and spectrum of pheochromocytoma: a study of 94 cases from a single center.Endocrine Connect.2018;7(1):186-192. doi:10.1530/EC-17-0321Uslar T, SanFrancisco IF, Olmos R, et al.Clinical presentation and perioperative management of pheochromocytomas and paragangliomas: a 4-decade experience.J Endocr Soc. 2021;22;5(10):bvab073. doi:10.1210/jendso/bvab073Zhou J, Xuan H, Miao Y, Hu J, Dai Y.Acute cardiac complications and subclinical myocardial injuries associated with pheochromocytoma and paraganglioma.BMC Cardiovasc Disord.2021;21(1):203. doi:10.1186/s12872-021-02013-6Y-Hassan S, Falhammar H.Cardiovascular Manifestations and Complications of Pheochromocytomas and Paragangliomas.J Clin Med.2020;9(8):2435. doi:10.3390/jcm9082435Jameson JL, De Groot LJ, de Kretser DM, et al, eds.Endocrinology: Adult and Pediatric.7th ed. Philadelphia, PA: Elsevier Saunders; 2016Y-Hassan S, Falhammar H.Cardiovascular Manifestations and Complications of Pheochromocytomas and Paragangliomas.J Clin Med.2020;9(8):2435. doi:10.3390/jcm9082435Y-Hassan S, Falhammar J.Pheochromocytoma- and paraganglioma-triggered Takotsubo syndrome.Endocrine. 2019;65(3):483-493. doi:10.1007/s12020-019-02035-3
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Cancer Institute.Pheochromocytoma and paraganglioma treatment (PDQ)-health professional version.Falhammar H, Kjellman M, Calissendorff J.Initial clinical presentation and spectrum of pheochromocytoma: a study of 94 cases from a single center.Endocrine Connect.2018;7(1):186-192. doi:10.1530/EC-17-0321Uslar T, SanFrancisco IF, Olmos R, et al.Clinical presentation and perioperative management of pheochromocytomas and paragangliomas: a 4-decade experience.J Endocr Soc. 2021;22;5(10):bvab073. doi:10.1210/jendso/bvab073Zhou J, Xuan H, Miao Y, Hu J, Dai Y.Acute cardiac complications and subclinical myocardial injuries associated with pheochromocytoma and paraganglioma.BMC Cardiovasc Disord.2021;21(1):203. doi:10.1186/s12872-021-02013-6Y-Hassan S, Falhammar H.Cardiovascular Manifestations and Complications of Pheochromocytomas and Paragangliomas.J Clin Med.2020;9(8):2435. doi:10.3390/jcm9082435Jameson JL, De Groot LJ, de Kretser DM, et al, eds.Endocrinology: Adult and Pediatric.7th ed. Philadelphia, PA: Elsevier Saunders; 2016Y-Hassan S, Falhammar H.Cardiovascular Manifestations and Complications of Pheochromocytomas and Paragangliomas.J Clin Med.2020;9(8):2435. doi:10.3390/jcm9082435Y-Hassan S, Falhammar J.Pheochromocytoma- and paraganglioma-triggered Takotsubo syndrome.Endocrine. 2019;65(3):483-493. doi:10.1007/s12020-019-02035-3
National Cancer Institute.Pheochromocytoma and paraganglioma treatment (PDQ)-health professional version.
Falhammar H, Kjellman M, Calissendorff J.Initial clinical presentation and spectrum of pheochromocytoma: a study of 94 cases from a single center.Endocrine Connect.2018;7(1):186-192. doi:10.1530/EC-17-0321
Uslar T, SanFrancisco IF, Olmos R, et al.Clinical presentation and perioperative management of pheochromocytomas and paragangliomas: a 4-decade experience.J Endocr Soc. 2021;22;5(10):bvab073. doi:10.1210/jendso/bvab073
Zhou J, Xuan H, Miao Y, Hu J, Dai Y.Acute cardiac complications and subclinical myocardial injuries associated with pheochromocytoma and paraganglioma.BMC Cardiovasc Disord.2021;21(1):203. doi:10.1186/s12872-021-02013-6
Y-Hassan S, Falhammar H.Cardiovascular Manifestations and Complications of Pheochromocytomas and Paragangliomas.J Clin Med.2020;9(8):2435. doi:10.3390/jcm9082435
Jameson JL, De Groot LJ, de Kretser DM, et al, eds.Endocrinology: Adult and Pediatric.7th ed. Philadelphia, PA: Elsevier Saunders; 2016
Y-Hassan S, Falhammar J.Pheochromocytoma- and paraganglioma-triggered Takotsubo syndrome.Endocrine. 2019;65(3):483-493. doi:10.1007/s12020-019-02035-3
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