Does an insulinoma cause chest pain?

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Last updated: March 27, 2025View editorial policy

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From the Guidelines

Insulinoma does not typically cause chest pain as a primary symptom, and any chest pain experienced by a patient with insulinoma should be investigated for other potential causes. Insulinomas are rare pancreatic tumors that secrete excessive insulin, leading predominantly to hypoglycemia (low blood sugar) symptoms. The classic symptoms of insulinoma include confusion, dizziness, sweating, tremors, hunger, anxiety, weakness, and in severe cases, seizures or loss of consciousness, as described in studies such as 1 and 1. These symptoms occur due to the brain's dependence on glucose for energy. When an insulinoma releases too much insulin, blood glucose levels drop abnormally low, depriving the brain and other organs of necessary fuel.

According to the most recent guidelines for evaluating chest pain, such as the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline 1, chest pain characteristics and corresponding causes are well-established, and insulinoma is not typically associated with chest pain. The guideline describes anginal symptoms as retrosternal chest discomfort, which is different from the symptoms typically experienced by patients with insulinoma. If a patient with insulinoma experiences chest pain, it would be prudent to investigate other potential causes, such as cardiac issues, pulmonary problems, or gastrointestinal disorders, rather than attributing it directly to the insulinoma. However, severe hypoglycemia can sometimes cause heart palpitations or increased heart rate, which might be perceived as chest discomfort by some patients.

Key points to consider when evaluating a patient with insulinoma and chest pain include:

  • The classic symptoms of insulinoma, such as confusion, dizziness, and sweating, are not typically associated with chest pain
  • Chest pain should be investigated for other potential causes, such as cardiac issues or pulmonary problems
  • Severe hypoglycemia can sometimes cause heart palpitations or increased heart rate, which might be perceived as chest discomfort
  • Guidelines for evaluating chest pain, such as the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline 1, should be followed to determine the underlying cause of chest pain.

From the Research

Insulinoma and Chest Pain

  • There are no direct references to chest pain as a symptom of insulinoma in the provided studies 2, 3, 4, 5, 6.
  • The studies discuss the typical symptoms of insulinoma, which include neuroglycopenic and autonomic sympathetic symptoms, such as seizures, adrenergic symptoms, and hypoglycemia 4, 5.
  • The primary focus of the studies is on the diagnosis, treatment, and management of insulinoma, with no mention of chest pain as a related symptom 2, 3, 4, 5, 6.
  • As a result, there is no evidence to suggest that an insulinoma directly causes chest pain, based on the provided studies 2, 3, 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Insulinoma; a diagnostic challenge: a case report.

JPMA. The Journal of the Pakistan Medical Association, 2025

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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