What are the symptoms of pheochromocytoma?

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From the Guidelines

Pheochromocytomas typically cause symptoms related to excessive catecholamine release, including episodic high blood pressure, severe headaches, heart palpitations, and excessive sweating, as noted in the most recent guidelines 1.

Symptoms of Pheochromocytoma

The symptoms of pheochromocytoma can vary widely in severity and frequency, but commonly include:

  • Episodic high blood pressure
  • Severe headaches
  • Heart palpitations
  • Excessive sweating
  • Anxiety
  • Tremors
  • Facial flushing
  • Nausea
  • Abdominal or chest pain These episodes, often called "spells" or "attacks," can last minutes to hours and may be triggered by certain activities, medications, or foods.

Classic Triad of Symptoms

The classic triad of symptoms includes headaches, sweating, and tachycardia, though not all patients experience all three simultaneously, as mentioned in 1 and 1.

Asymptomatic Cases

Some patients may be asymptomatic with the tumor discovered incidentally during imaging for other conditions, highlighting the importance of screening and diagnosis, as discussed in 1 and 1.

Importance of Early Detection

Early detection and proper treatment of pheochromocytoma are crucial to reduce morbidity and mortality, as emphasized in the recent guidelines 1 and studies 1.

From the FDA Drug Label

In patients with pheochromocytoma, who produce excessive amounts of norepinephrine and epinephrine... Most patients with pheochromocytoma treated with metyrosine experience decreased frequency and severity of hypertensive attacks with their associated headache, nausea, sweating, and tachycardia The symptoms of pheochromocytoma include:

  • Hypertensive attacks
  • Headache
  • Nausea
  • Sweating
  • Tachycardia 2

From the Research

Symptoms of Pheochromocytoma

The symptoms of pheochromocytoma can be highly variable and may mimic other diseases, making diagnosis challenging 3. Some common symptoms include:

  • Sustained or paroxysmal hypertension
  • Severe headaches
  • Palpitations
  • Sweating
  • Paroxysmal symptoms, such as episodic headache, sweating, and tachycardia 4, 5
  • Classic triad of episodic headache, sweating, and tachycardia, present in a subset of patients 3, 5

Clinical Presentation

The clinical presentation of pheochromocytoma can vary, with some patients presenting with:

  • Incidentalomas, where the tumor is discovered incidentally during imaging for other reasons 5
  • Suspected pheochromocytoma, where the patient presents with symptoms suggestive of the disease 5
  • Pheochromocytoma crisis, a life-threatening condition that requires immediate attention 5
  • Atypical presentations, such as cerebellar infarct and aortic thrombi, which can make diagnosis challenging 4

Hormonal Excess

Pheochromocytomas are characterized by excess catecholamine production, which can lead to:

  • Elevated levels of noradrenaline and normetanephrine 5
  • Hypertension, which can be sustained or paroxysmal 3, 5
  • Other symptoms related to catecholamine excess, such as palpitations and sweating 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

An Interesting Presentation of Pheochromocytoma.

Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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