Materiały źródłowe

• #1 Pheochromocytoma: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23373-pheochromocytoma

  Signs and symptoms of pheochromocytoma happen when the tumor releases too much adrenaline (epinephrine) or noradrenaline (norepinephrine) into your blood. However, some pheochromocytoma tumors dont make extra adrenaline or noradrenaline and dont cause symptoms (are asymptomatic). […] Common symptoms of pheochromocytoma include: High blood pressure (hypertension). Headache. Excessive sweating for no known reason. A pounding, fast or irregular heartbeat. Feeling shaky. […] A person with a pheochromocytoma could have sustained high blood pressure (the most common symptom of pheochromocytoma) or it may come and go. […] People with pheochromocytomas may also experience paroxysmal attacks, which are chronic episodes of high blood pressure that often lead to headaches, irregular heartbeats (palpitations) and excessive sweating (diaphoresis). These episodes can happen anywhere from several times a day to a couple of times a month.

• #1 Pheochromocytoma – Wikipedia

  https://en.wikipedia.org/wiki/Pheochromocytoma

  The symptoms of a sympathetic pheochromocytoma are related to sympathetic nervous system hyperactivity. The classic triad includes headaches (likely related to elevated blood pressure, or hypertension), tachycardia/elevated heart rate, and diaphoresis (excessive sweating, particularly at night, also known as hyperhidrosis). However, patients are unlikely to experience continuous symptoms. Due to the paroxysmal nature of catecholamine synthesis and release, patients may experience „attacks” or „spells” where they are suddenly overwhelmed with signs and symptoms of their tumor. Attacks can occur spontaneously (without warning) or may be triggered by a variety of pharmaceutical agents (including histamine, metoclopramide, glucagon and adrenocorticotropic hormone), foods that contain tyramine (cheese and wine), intraoperative tumor manipulation, intubation, or during anesthetic induction.

• #1 Pheochromocytoma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pheochromocytoma/symptoms-causes/syc-20355367

  A pheochromocytoma can cause large changes in blood pressure. When that happens, it’s called a spell. Blood pressure may return to a healthy range between spells. That can make it harder to diagnose a pheochromocytoma. […] With a pheochromocytoma, the tumor releases hormones that can cause various symptoms. They include high blood pressure, headache, sweating and symptoms of a panic attack. If a pheochromocytoma isn’t treated, serious or life-threatening damage to other body systems can happen. […] A pheochromocytoma often causes the following symptoms: High blood pressure. Headache. Heavy sweating. Rapid heartbeat. […] Some people with pheochromocytomas also have symptoms such as: Nervous shaking. Skin that turns a lighter color, also called pallor. Shortness of breath. Panic attack-type symptoms, which can include sudden intense fear. Anxiety or a sense of doom. Vision problems. Constipation. Weight loss.

• #1

  https://link.springer.com/article/10.1186/s40200-016-0226-x

  Pheochromocytoma is a rare disease but with high mortality if it is not being diagnosed early. […] The most prevalent signs and symptoms reported were hypertension (pooled sensitivity of 80.7 %), headache (pooled sensitivity of 60.4 %), palpitation (pooled sensitivity of 59.3 %) and diaphoresis (pooled sensitivity of 52.4 %). […] The classic triad of headache, palpitation and diaphoresis in hypertensive patients had the LR+ 6.312 (95 % CI 0.217183.217) and LR-0.139 (95 % CI 0.0590.331). Surprisingly, hypertension was not important in clinical suspicion of pheochromocytoma, and even normotension increased the probability of the disease. […] The clinical presentation varies, ranging from an adrenal incidentaloma to hypertensive crises with associated cerebrovascular or cardiac complications.

• #1 Pheochromocytoma Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/124059-clinical

  Symptoms and signs of pheochromocytoma include the following: Headache, Diaphoresis, Palpitations, Tremor, Nausea, Weakness, Pallor, Anxiety, sense of doom, Epigastric pain, Flank pain, Constipation, Weight loss. […] The classic history of a patient with a pheochromocytoma includes spells characterized by headaches, palpitations, and diaphoresis in association with severe hypertension. These 4 characteristics together are strongly suggestive of a pheochromocytoma. In the absence of these 3 symptoms and hypertension, the diagnosis may be excluded. […] The spells may vary in occurrence from monthly to several times per day, and the duration may vary from seconds to hours. Typically, they worsen with time, occurring more frequently and becoming more severe as the tumor grows. […] Clinical signs associated with pheochromocytomas include the following: Hypertension: Paroxysmal in 50% of cases, Postural hypotension (from volume contraction), Hypertensive retinopathy, Weight loss, Pallor, Fever, Tremor, Tachyarrhythmias, Pulmonary edema, Cardiomyopathy, Diabetes mellitus, Ileus.

• #1 Pheochromocytoma Symptoms, Treatment, Diagnosis & More

  https://pheopara.org/education/pheochromocytoma

  Pheochromocytomas produce an excess amount of catecholamine hormone, which include norepinephrine (noradrenaline), epinephrine (adrenaline), and dopamine. The release of catecholamines can cause persistent or episodic high blood pressure, headache, sweating and other symptoms. If left untreated, a pheochromocytoma can result in severe or life-threatening damage to other body systems, especially the cardiovascular system. […] The signs and symptoms of pheochromocytoma can be caused by a number of different conditions. […] Signs or symptoms of pheochromocytomas may include: High blood pressure, Rapid or forceful heartbeat, Profound sweating without any reason, Severe, throbbing headache, Tremors, Paleness in the face, Shortness of breath, Sensation of panic. […] Although high blood pressure is a primary sign of a pheochromocytoma, most people with high blood pressure don’t have a pheochromocytoma, and not all patients with a pheochromocytoma have hypertension. It is common for pheo para patients to experience spells where symptoms arise quickly and intensely.

• #1 Pheochromocytoma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pheochromocytoma/symptoms-causes/syc-20355367

  Most often, the symptoms of pheochromocytoma come and go. When they start suddenly and keep coming back, they’re known as spells or attacks. These spells may or may not have a trigger that can be found. […] High blood pressure is one of the main symptoms of a pheochromocytoma. But most people who have high blood pressure don’t have an adrenal tumor.

• #1 Pheochromocytoma: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/124059-overview

  Classically, pheochromocytoma manifests as spells with the following 4 characteristics: […] Over time, spells tend to occur more frequently and become more severe as the tumor grows. […] Hypertension is the most common complication. Cardiac arrhythmias, such as atrial and ventricular fibrillation, may occur because of excessive plasma catecholamine levels. […] A pheochromocytoma-induced hypertensive crisis may precipitate hypertensive encephalopathy, which is characterized by altered mental status, focal neurologic signs and symptoms, or seizures. Other neurologic complications include stroke from cerebral infarction or an embolic event secondary to a mural thrombus from dilated cardiomyopathy. Intracerebral hemorrhage also may occur, because of uncontrolled hypertension. […] The 5-year survival rate for people with nonmalignant pheochromocytomas is greater than 95%. In patients with malignant pheochromocytomas, the 5-year survival rate is less than 50%. […] Although pheochromocytomas are rare, making the diagnosis is critical because the malignancy rate is 10%, pheochromocytomas may be associated with a familial syndrome, they may precipitate life-threatening hypertension, and the patient may be cured completely with their removal.

• #1 Pheochromocytoma: Not your everyday diagnosis

  https://www.myamericannurse.com/pheochromocytoma-not-your-everyday-diagnosis/

  Looking scared, Joan Ware, age 46, comes to the emergency department (ED) for the third time in the last 2 months. She says she just doesn’t understand what’s wrong; she’s always been healthy. Her symptoms, she says, begin suddenly with a headache, sweating, and palpitations. Then come the attacks in which she experiences severe fright, a feeling of doom, chest tightness, and light-headedness. The episodes are sporadic and distressing. […] Signs and symptoms typically occur weekly, but may occur several times a day or every few months. Other signs and symptoms include headache, sweating, palpitations, chest pain, hot flashes, and psychological symptoms, such as anxiety, despair, and even aggression. Rarely, a pheochromocytoma is asymptomatic. Complications of pheochromocytomas include pulmonary edema, cardiac arrhythmias, myocarditis, dilated congestive cardiomyopathy, cerebral vascular accidents, and renal failure. Without effective treatment, the complications will almost inevitably be fatal.

• #1 What are common symptoms of pheochromocytoma? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/pheochrom/conditioninfo/symptoms

  Pheochromocytoma can cause a variety of signs and symptoms, depending on the type and location of the tumor. […] Some of the most common signs and symptoms include (in alphabetical order): Abdominal pain, Constipation, Chest pain, Dizziness, Elevated blood sugar, Facial flushing (redness), High blood pressure, Increased respiratory rate, Nausea, Nervousness, anxiety, and irritability, Pale skin tone, Rapid heart rate and heart palpitations, Severe headaches, Sweating, Visual disturbances, Weight loss.

• #1 Pheochromocytoma in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=pheochromocytoma-in-children-90-P01971

  The most common symptom is high blood pressure, which can be very high. The high blood pressure can cause: […] Other symptoms can occur a bit differently in each child. They may include: […] The symptoms of pheochromocytoma can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis. […] Treatment is done by removing the tumor or tumors with surgery. Most people are cured with surgery. But in some people, the tumor can grow back. […] Complications can include heart damage or stroke caused by high blood pressure.

• #1 Pheochromocytoma and ParagangliomaAdrenal – NETRF

  https://netrf.org/old-for-patients/nets-info/tumor-site/adrenal/

  Signs and symptoms of pheochromocytoma and paraganglioma may occur when one of the following events happens: Hard physical activity, A physical injury or having a lot of emotional stress, Childbirth, Going under anesthesia, Surgery, including procedures to remove the tumor, Eating foods high in tyramine (such as red wine, chocolate, and cheese).

• #1 Pheochromocytoma > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/pheochromocytoma

  Symptoms include high blood pressure, headache, sweating, rapid heart rate. […] In people with pheochromocytomas, the cells that make up the tumors produce and release excessive levels of these hormones, which can lead to high blood pressure, heart palpitations, sweating, and headache, among other symptoms. […] Pheochromocytomas tend to grow over time, and as they get larger, symptoms may be more severe, last longer, and occur more frequently. […] Without treatment, pheochromocytomas can lead to life-threatening high blood pressure and complications including heart attack, heart arrhythmias, pulmonary edema, heart failure, and stroke, among others. […] With treatment, the outlook is better. In many cases, surgical removal of the tumor can cure people of the disease. Some people, however, may still have high blood pressure even after surgery. This can be treated with medication. […] There is also a risk that the tumor will return after surgery. This can happen years after initial treatment.

• #1 Pheochromocytoma: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/318203

  A person with pheochromocytoma may experience headaches, heart palpitations, and sweating. […] Symptoms of pheochromocytoma vary from person to person. Around 60% of people with this condition experience either constant or sporadic high blood pressure. […] The most common symptoms of pheochromocytoma are headaches, heart palpitations, and sweating. […] Symptoms may last for seconds or hours. They tend to worsen over time and become more frequent as the tumor grows. […] Pheochromocytoma can disturb the normal functioning of the adrenal glands. This can increase the risk of an adrenergic crisis, which occurs when bursts of adrenal hormones enter the bloodstream. […] Symptoms of an adrenergic crisis include extremely high blood pressure and a rapid heart rate. […] Most pheochromocytomas are benign. However, without treatment, they can lead to complications. […] Pheochromocytoma is rare, and it is not usually cancerous. However, without treatment, it can lead to serious complications. […] Removing the tumor will usually cause the symptoms to go away. However, a doctor may recommend lifelong follow up, as some pheochromocytomas can recur.

• #1 Pheochromocytoma – Endocrinology Advisor

  https://www.endocrinologyadvisor.com/ddi/pheochromocytoma/

  Pheochromocytoma is a rare neuroendocrine disorder in which a tumor grows from chromaffin cells within the adrenal medulla of the adrenal glands. This tumor causes the continuous overproduction of epinephrine and norepinephrine, which, if left without pheochromocytoma treatment, can lead to severe or life-threatening damage to other body systems. […] The presentation of pheochromocytoma varies widely. Pheochromocytoma can be asymptomatic diagnosed incidentally during imaging procedures for unrelated conditions or found on routine periodic screenings for those patients that have been identified with genetic predispositions. […] It may also present with symptomatic attacks ranging in frequency from a couple of times a month to multiple times per day. These pheochromocytoma symptoms occur due to the excessive release of catecholamines (such as norepinephrine and epinephrine).

• #1 Pheochromocytoma FAQs: Treatment & Diagnosis – Endocrine Surgery | UCLA Health

  https://www.uclahealth.org/medical-services/surgery/endocrine-surgery/conditions-treated/adrenal/adrenal-tumors/pheochromocytoma/pheochromocytoma-treatment-diagnosis

  For this reason, pheochromocytomas are regarded as quite likely the single most high risk tumor that physicians treat. Because they are essential regulators of blood pressure, catecholamines are normally released as part of a delicate balance. The fluctuating catecholamine levels seen in pheochromocytoma patients can cause organ damage from dangerously high blood pressure, leading to: Death, Heart attack, Stroke, Kidney failure. […] Untreated pheochromocytoma is frequently lethal. A small fraction of patients require further treatment for malignant pheochromocytoma after initial surgery. […] Inherited pheochromocytoma patients are much more likely to develop multiple tumors and tumors lying outside of the adrenal gland. These must be carefully detected prior to any attempt at surgery. […] The likelihood of malignant pheochromocytoma appears to depend heavily on the underlying mutation. For most sporadic pheochromocytomas, less than 10% turn out to be malignant. The highest rate of malignancy is associated with the SDHB mutation (familial pheochromocytoma/paraganglioma syndrome) which may carry malignancy rates above 50%.

• #1 Pheochromocytoma – Wikipedia

  https://en.wikipedia.org/wiki/Pheochromocytoma

  In pregnancy, pheochromocytoma is associated with significant maternal and fetal mortality, mainly due to hypertensive crisis in the mother and intrauterine growth restriction in the fetus. […] Misdiagnosis of pheochromocytoma can be deadly, as beta-blockers, often prescribed for hypertension, can lead to unopposed alpha in the context of pheochromocytoma. Most mortality associated with diagnosed pheochromocytoma came from surgery and hypertensive crisis, but mortality has greatly improved. […] Hypertensive crisis: Pheochromocytoma-related hypertensive emergencies are one of the most feared clinical manifestations. Attacks are random and may occur secondary to a trigger (see Signs and Symptoms above) or spontaneously after a catecholamine surge. The prevailing symptom is elevated systolic blood pressure (200 mmHg) that is unresponsive to traditional treatment regimens and threatens end-organ damage. Patients require immediate, life-saving treatment to prevent further damage to other organs and/or death.

• #1 Pheochromocytoma: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23373-pheochromocytoma

  The prognosis (outlook) for pheochromocytoma is usually good if its treated. Approximately 90% of pheochromocytomas are successfully removed by surgery. […] If pheochromocytomas are left untreated, they can potentially cause serious, life-threatening complications, including: Heart muscle disease (cardiomyopathy). Inflammation of your heart muscle (myocarditis). Uncontrolled bleeding in your brain (cerebral hemorrhaging). Accumulation of fluid in your lungs (pulmonary edema). […] Some people with a pheochromocytoma may also be at risk of developing a stroke or heart attack (myocardial infarction).

• #1 Pheochromocytoma Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/124059-clinical

  Sinus tachycardia (presenting as palpitations) is the most common cardiac rhythm abnormality in patients with pheochromocytoma, but more serious ventricular arrhythmias or conduction disturbances may also occur. Other cardiac manifestations include reversible dilated or hypertrophic cardiomyopathy; Takotsubo cardiomyopathy has gained increasing recognition.

• #1 Pheochromocytoma Symptoms, Treatment, Diagnosis & More

  https://pheopara.org/education/pheochromocytoma

  In 15%-25% of the cases of pheochromocytoma, the disease is metastatic and has spread to other organs. […] All pheochromocytoma have the potential to become metastatic, or spread to other parts of the body. This happens in approximately 15-25% of pheo cases. […] There are currently no cures for metastatic pheochromocytoma. However, existing treatment options may reduce tumors and prolong survival. Some patients live for decades with metastatic pheochromocytoma. The prognosis for metastatic pheo is highly variable and is dependent upon the size of the primary tumor (tumors larger than 5-6 cm are more likely to metastasize), levels of methoxytyramine (a metabolite of the neurotransmitter dopamine which can be measured in the blood) and genetic status. Some genetic mutations are more likely to develop metastatic pheo.

• #1 Pheochromocytoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589700/

  The key elements of perioperative management are 4-fold. First, prevention of catecholamine surge is achieved through minimal handling of the lesion and avoiding spillage of tumor contents, particularly in cystic lesions. […] The risk of pheochromocytoma recurrence exists in both sporadic and familial cases. […] A recent meta-analysis estimates that the recurrence rate after curative surgery is low, at approximately 3%.

• #1 Pheochromocytoma – NCI

  https://www.cancer.gov/pediatric-adult-rare-tumor/rare-tumors/rare-endocrine-tumor/pheochromocytoma

  Some people with pheochromocytoma have symptoms, but others don’t. Symptoms may occur as often as several times a day to a couple of times per month. Some people may feel intense symptoms that last for a short period of time, called paroxysmal attacks. These symptoms can include: High blood pressure Headaches Irregular heartbeat Sweating […] Doctors estimate pheochromocytoma survival rates by how groups of people with pheochromocytoma have done in the past. Patients with a small pheochromocytoma that has not spread to other parts of the body have a five-year survival rate of about 95%. Patients with pheochromocytoma that has grown back (recurred) or spread to other parts of the body have a five-year survival rate between 34% and 60%.

• #1 Pheochromocytoma in Children | UVA Health Children’s

  https://childrens.uvahealth.com/services/pediatric-diabetes-endocrinology/pheochromocytoma

  Pheochromocytoma is a tumor that grows on the adrenal glands, which lie on top of the kidneys. The tumor’s cells secrete hormones such as epinephrine and norepinephrine. When present in normal amounts, these hormones help to regulate heart rate and blood pressure. In excessive amounts, these hormones cause: Very high blood pressure, Rapid heartbeat or palpitations, Excessive sweating, Severe headaches. 10 percent of those affected by this disease are children. Symptoms usually appear between the ages of 6 and 14. […] Your child may not have any symptoms. In children, pheochromocytoma can cause: High blood pressure, Severe headaches, Excessive sweating, Warmth, flushing, Fast heart rate and pounding heartbeat, Sensation of a panic attack, Blurred vision, Nausea, vomiting, constipation or diarrhea, Chest pain, Involuntary trembling, Pain in the lower chest or upper abdomen, Increased appetite, Weight loss, Excessive thirst and urination, Insomnia, Tingling, burning or numbness in the legs and feet, Shortness of breath, Muscle weakness, Anxiety, Trouble coping with high temperature.

• #1 Paraganglioma and Pheochromocytoma | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/paraganglioma-and-pheochromocytoma

  For PCCs/PGLs, the most common symptoms are: High blood pressure, Rapid pulse, Heart palpitations, Headache, Dizziness, Poor weight gain despite good appetite, Abdominal pain, Nausea, Vomiting, Pale skin, Clammy skin, Sweating, Growth failure. […] Because many of these symptoms can also point to other conditions, it’s important to have your child diagnosed by a qualified medical professional right away.

• #1 Pheochromocytoma | Adrenal Glands | MedlinePlus

  https://medlineplus.gov/pheochromocytoma.html

  Pheochromocytoma is a rare tumor that usually starts in the cells of one of your adrenal glands. Although they are usually benign, pheochromocytomas often cause the adrenal gland to make too many hormones. This can lead to high blood pressure and cause symptoms such as : Headaches, Sweating, Pounding of the heart, Being shaky, Being extremely pale. […] Sometimes pheochromocytoma is part of another condition called multiple endocrine neoplasia syndrome (MEN). People with MEN often have other cancers and other problems involving hormones.

• #1 Pheochromocytoma – Wikipedia

  https://en.wikipedia.org/wiki/Pheochromocytoma

  Other clinical manifestations that have been reported include (in no particular order): Pallor, Heat intolerance, Weight loss, Chest and/or abdominal discomfort, Palpitations, Nausea/vomiting, Constipation, Orthostatic hypotension becoming light-headed or dizzy after swiftly changing positions, Psychiatric manifestations: Anxiety, panic attacks, nervousness, tremors, Hyperglycemia (high blood sugar). […] While the symptoms of a pheochromocytoma are quite common, the disease has been referred to as „the great mimic”. It is estimated that approximately 0.1% of patients with hypertension have a pheochromocytoma, and it is often misdiagnosed as essential hypertension. As symptoms are often paroxysmal (episodic/sporadic), patients may not immediately seek treatment as the problem „disappears on its own.” Furthermore, when pictured in the ideal clinical scenario (an older woman in her mid-50s), the spontaneous attacks of flushing, sweating, and a racing heart may be mistaken for pre-menopausal related hot flashes. Unmanaged pheochromocytoma is dangerous and can lead to serious, potentially fatal, complications, including stroke and hypertension-induced organ damage. The cardiovascular system is the most commonly involved.

• #1 Pheochromocytoma – Pre-Diagnosis, Signs & Symptoms – Cancer Chat | Cancer Research UK

  https://cancerchat.cancerresearchuk.org/f/pre-diagnosis-signs-symptoms/83203/pheochromocytoma

  Hi all, I don’t really know where to start. On the 7th of January I was awoken in the early hours to my heart pounding out of my chest, short of breath, pressure in head, nausea, diarrhoea, agitated with a feeling of impending doom, once my heart rate started coming back down I started shaking uncontrollably. […] These adrenaline surges are horrific when they happen im convinced dying. […] I have been having these episodes intermittently for the last 18 months. Usually put down to vestibular migraine. […] Without warning in my sleep I will suddenly wake up with body and head in absolute crisis, head spinning, feeling like it’s the end of the world. Crawl to the loo and once that bit is over crawl back into bed and then spend the next 24 hours recovering. I feel absolutely destroyed after an attack.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Causes-and-Symptoms-of-Pheochromocytoma.aspx

  Pheochromocytoma can have exceptionally variable clinical presentation from rare and escalating hypercatecholaminergic incidents, through rather stable hypertension, to dire and clinically malignant illness that can be complicated by hypertensive crisis, acute myocardial infarction, stroke, and a myriad of other emergent conditions. […] Signs and symptoms of pheochromocytoma can be highly varied, reflecting the hemodynamic and metabolic activities of the catecholamines that are produced and secreted by the tumors. […] High blood pressure or hypertension is the most common sign and a cardinal feature of pheochromocytoma, which may be sustained or paroxysmal. […] The occurrence of the triad that includes headache, palpitations, and excessive generalized sweating in patients with hypertension should immediately arouse suspicion that pheochromocytoma is the underlying cause.

• #1 Pheochromocytoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589700/

  Pheochromocytomas can present with varied clinical presentations depending on their secretory patterns. […] Epinephrine-secreting tumors often cause paroxysmal hypertensive crises but may also have a silent course. In contrast, norepinephrine-secreting tumors typically result in essential hypertension. […] Patients with subclinical disease are also at significant cardiovascular risk, with case reports describing sudden hypertensive crises leading to sudden death. […] Examination findings may include: Hypertension, Tachycardia, Anxiety, Diaphoresis. […] The definitive treatment for pheochromocytoma is surgical resection, with preoperative – and -adrenergic blockade being crucial. […] Most sporadic tumors are unilateral. […] According to the Endocrine Society Clinical Practice Guidelines, adrenalectomy via a minimally invasive approach is the preferred treatment for most unilateral adrenal pheochromocytomas.

• #1 Pheochromocytoma-related Headache and Symptoms that Should Not be Overlooked: A Case Report

  https://www.j-nn.org/journal/view.php?number=177

  Pheochromocytoma is a rare tumor that originates from catecholamine-secreting chromaffin cells derived from the ectodermic neural system and is mostly situated in the adrenal medulla. The annual incidence of pheochromocytoma is approximately 0.8 per 100,000 person-years. A triad of symptoms of paroxysmal headache, excessive sweating, and heart palpitations should raise suspicion of pheochromocytoma, especially when concurrent hypertension exists; however, less than 25% of patients with pheochromocytoma present all three. Usually, headaches due to pheochromocytoma occur simultaneously with an abrupt increase in blood pressure. […] In this case, because no abnormalities in whole brain work-ups were found, the headache was treated with medicine as a primary headache; if the pheochromocytoma was not found, it could have caused other serious complications. Because of this, even if all neurological disease is excluded by brain work-up, other causes that can cause severe headaches should not be overlooked.

• #2 Pheochromocytoma Symptoms, Treatment, Diagnosis & More

  https://pheopara.org/education/pheochromocytoma

  Pheochromocytomas produce an excess amount of catecholamine hormone, which include norepinephrine (noradrenaline), epinephrine (adrenaline), and dopamine. The release of catecholamines can cause persistent or episodic high blood pressure, headache, sweating and other symptoms. If left untreated, a pheochromocytoma can result in severe or life-threatening damage to other body systems, especially the cardiovascular system. […] The signs and symptoms of pheochromocytoma can be caused by a number of different conditions. […] Signs or symptoms of pheochromocytomas may include: High blood pressure, Rapid or forceful heartbeat, Profound sweating without any reason, Severe, throbbing headache, Tremors, Paleness in the face, Shortness of breath, Sensation of panic. […] Although high blood pressure is a primary sign of a pheochromocytoma, most people with high blood pressure don’t have a pheochromocytoma, and not all patients with a pheochromocytoma have hypertension. It is common for pheo para patients to experience spells where symptoms arise quickly and intensely.

• #2 Pheochromocytoma Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/124059-clinical

  Symptoms and signs of pheochromocytoma include the following: Headache, Diaphoresis, Palpitations, Tremor, Nausea, Weakness, Pallor, Anxiety, sense of doom, Epigastric pain, Flank pain, Constipation, Weight loss. […] The classic history of a patient with a pheochromocytoma includes spells characterized by headaches, palpitations, and diaphoresis in association with severe hypertension. These 4 characteristics together are strongly suggestive of a pheochromocytoma. In the absence of these 3 symptoms and hypertension, the diagnosis may be excluded. […] The spells may vary in occurrence from monthly to several times per day, and the duration may vary from seconds to hours. Typically, they worsen with time, occurring more frequently and becoming more severe as the tumor grows. […] Clinical signs associated with pheochromocytomas include the following: Hypertension: Paroxysmal in 50% of cases, Postural hypotension (from volume contraction), Hypertensive retinopathy, Weight loss, Pallor, Fever, Tremor, Tachyarrhythmias, Pulmonary edema, Cardiomyopathy, Diabetes mellitus, Ileus.

• #2 Pheochromocytoma: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23373-pheochromocytoma

  Signs and symptoms of pheochromocytoma happen when the tumor releases too much adrenaline (epinephrine) or noradrenaline (norepinephrine) into your blood. However, some pheochromocytoma tumors dont make extra adrenaline or noradrenaline and dont cause symptoms (are asymptomatic). […] Common symptoms of pheochromocytoma include: High blood pressure (hypertension). Headache. Excessive sweating for no known reason. A pounding, fast or irregular heartbeat. Feeling shaky. […] A person with a pheochromocytoma could have sustained high blood pressure (the most common symptom of pheochromocytoma) or it may come and go. […] People with pheochromocytomas may also experience paroxysmal attacks, which are chronic episodes of high blood pressure that often lead to headaches, irregular heartbeats (palpitations) and excessive sweating (diaphoresis). These episodes can happen anywhere from several times a day to a couple of times a month.

• #2

  https://link.springer.com/article/10.1186/s40200-016-0226-x

  The vast majority of symptoms and signs are attributable to the excess of catecholamines released by tumors continuously or paroxysmally. […] In addition to the classic triad, patients often experience other symptoms such as anxiety, dyspnea, chest, abdominal or flank pain, nausea and vomiting, tremor, flushing, dizziness, visual symptoms such as blurred vision, and paresthesia. […] The sudden out-pouring of epinephrine has been postulated as causing an elevation in body temperature by a combination of inducing hypermetabolism and impairing heat dissipation as a consequence of cutaneous vasoconstriction. […] Hypermetabolism caused by catecholamines can cause weakness, fatigue and weight loss. […] The presence of classic triad of headache, palpitation and sweating raises the clinical suspicion 6 times. […] At last, when we look at the table of LRs, it seems that no single sign or symptom alone is helpful in diagnosis of pheochromocytoma. Rather, the combination (such as the classic triad) can be probably important for this aim.

• #2 Pheochromocytoma FAQs: Treatment & Diagnosis – Endocrine Surgery | UCLA Health

  https://www.uclahealth.org/medical-services/surgery/endocrine-surgery/conditions-treated/adrenal/adrenal-tumors/pheochromocytoma/pheochromocytoma-treatment-diagnosis

  High blood pressure (hypertension) is the most common problem attributed to pheochromocytomas. This is a result of increased release of the catecholamines epinephrine and norepinephrine. Because each tumor is different from the next, patients with pheochromocytomas may experience either consistently high blood pressure (due to constant hormone release) or episodic peaks in blood pressure (due to random bursts of hormone release). […] Symptoms of pheochromocytoma are often related to surges in blood pressure. People commonly report feeling a sudden adrenaline rush for no apparent reason, and this can happen up to several times per day. Many patients report that exercise may provoke pheochromocytoma surges. Typical symptoms include: Severe Headache, Palpitations or rapid heart rate, Profuse sweating, Flushing or feeling hot, Chest pain or chest pressure.

• #2 Pheochromocytoma – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/adrenal-disorders/pheochromocytoma

  Hypertension, which is paroxysmal in 45% of patients, occurs in most patients with pheochromocytomas and is prominent. […] Common symptoms and signs are Tachycardia, Diaphoresis, Postural hypotension, Tachypnea, Cold and clammy skin, Severe headache, Angina, Palpitations, Nausea and vomiting, Epigastric pain, Visual disturbances, Dyspnea, Paresthesias, Constipation, A sense of impending doom. […] Paroxysmal attacks may be provoked by palpation of the tumor, postural changes, abdominal compression or massage, induction of anesthesia, emotional trauma, unopposed beta-blockade, or micturition. […] In older patients, severe weight loss with persistent hypertension is suggestive of pheochromocytoma. […] Physical examination, except for the presence of hypertension, is usually normal unless done during a paroxysmal attack. […] However, cardiac and cerebrovascular events are more frequent in patients with pheochromocytomas than in others with similar blood pressure levels.

• #2 Pheochromocytoma Symptoms, Treatment, Diagnosis & Prognosis

  https://www.medicinenet.com/pheochromocytoma/article.htm

  Someone with a pheochromocytoma usually has three classic symptoms — headache, sweating, and heart palpitations (a fast heartbeat) in association with markedly elevated blood pressure (hypertension). Other conditions that may accompany these classic symptoms are as follows: anxiety, nausea, tremors, weakness, abdominal pain, and weight loss. […] Pheochromocytomas are present in only about 0.2% of all people with high blood pressure. There are certain conditions, however, in which the diagnosis of pheochromocytoma may rank high on the list of possibilities; they are discussed below. […] Pheochromocytoma is benign in most cases, and if blood pressure-related surgical complications can be avoided, the likelihood of a cure is excellent. Both malignant and benign pheochromocytomas can recur after surgery. The statistics vary from one study to the next, but recurrence rates average around 10%. Therefore, long-term follow-up care after surgery is very important to keep outlooks fair to good with additional appropriate treatments of medicine or surgery. […] In the low percentage of these already rare tumors in which malignant behavior is evident, survival may still be quite prolonged, as the pace of the disease may still be slow.

• #2 Phaeochromocytoma

  https://www.nhs.uk/conditions/phaeochromocytoma/

  A phaeochromocytoma can cause the adrenal glands to produce too much of these hormones, which often results in problems such as heart palpitations and high blood pressure. […] The symptoms of a phaeochromocytoma tend to be unpredictable, often occurring in sudden attacks lasting from a few minutes to an hour. […] The attacks may last longer, and become more frequent and severe, as the tumour grows. […] The symptoms and signs of a phaeochromocytoma can include: headaches, heavy sweating, heart palpitations, high blood pressure, a pale face, feeling or being sick, feeling anxious or panicky, shakiness (tremor). […] Some people with a phaeochromocytoma do not have symptoms, and their condition is either never diagnosed or only discovered during tests for another problem, such as high blood pressure. Others have symptoms for many years before a phaeochromocytoma is diagnosed.

• #2 Pheochromocytoma: What is a Pheochromocytoma? – Endocrine Surgery | UCLA Health

  https://www.uclahealth.org/medical-services/surgery/endocrine-surgery/conditions-treated/adrenal/adrenal-tumors/pheochromocytoma

  Pheochromocytoma Symptoms […] Severe headaches […] Palpitations […] Rapid heart rate […] Sweating […] Flushing […] Chest pain […] Abdominal pain […] Nervousness […] Irritability […] The most common symptom of pheochromocytoma is hypertension (high blood pressure). Patients can have persistent/chronic high blood pressure, or high blood pressure only during episodes/attacks. A common clinical feature of pheochromocytomas is an attack of symptoms (listed above) that may be frequent but occur at irregular intervals (sporadic). These attacks may worsen in severity, duration and frequency as the tumor grows. Some patients have attacks brought on by physical or emotional stress, while others are awakened from sleep with symptoms.

• #2 Pheochromocytoma – Office Instructions – Vital Signs Medical Associates

  https://www.vitalsignsmed.com/PracticeManager/patient_v2/instructions.php?id=2037525&iid=5386

  Pheochromocytoma is a rare tumor of adrenal gland tissue. It results in the release of too much epinephrine and norepinephrine, hormones that control heart rate, metabolism, and blood pressure. […] Symptoms occur during attacks, which happen when the tumor releases hormones. The attacks usually last 15 to 20 minutes. The attacks may increase in frequency, length, and severity as the tumor grows. High blood pressure may occur from time to time. […] Other symptoms that can occur with this disease: Hand tremor, High blood pressure, Sleeping difficulty.

• #2 Pheochromocytoma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pheochromocytoma/symptoms-causes/syc-20355367

  A pheochromocytoma can cause large changes in blood pressure. When that happens, it’s called a spell. Blood pressure may return to a healthy range between spells. That can make it harder to diagnose a pheochromocytoma. […] With a pheochromocytoma, the tumor releases hormones that can cause various symptoms. They include high blood pressure, headache, sweating and symptoms of a panic attack. If a pheochromocytoma isn’t treated, serious or life-threatening damage to other body systems can happen. […] A pheochromocytoma often causes the following symptoms: High blood pressure. Headache. Heavy sweating. Rapid heartbeat. […] Some people with pheochromocytomas also have symptoms such as: Nervous shaking. Skin that turns a lighter color, also called pallor. Shortness of breath. Panic attack-type symptoms, which can include sudden intense fear. Anxiety or a sense of doom. Vision problems. Constipation. Weight loss.

• #2 Pheochromocytoma in Children | UVA Health Children’s

  https://childrens.uvahealth.com/services/pediatric-diabetes-endocrinology/pheochromocytoma

  Pheochromocytoma is a tumor that grows on the adrenal glands, which lie on top of the kidneys. The tumor’s cells secrete hormones such as epinephrine and norepinephrine. When present in normal amounts, these hormones help to regulate heart rate and blood pressure. In excessive amounts, these hormones cause: Very high blood pressure, Rapid heartbeat or palpitations, Excessive sweating, Severe headaches. 10 percent of those affected by this disease are children. Symptoms usually appear between the ages of 6 and 14. […] Your child may not have any symptoms. In children, pheochromocytoma can cause: High blood pressure, Severe headaches, Excessive sweating, Warmth, flushing, Fast heart rate and pounding heartbeat, Sensation of a panic attack, Blurred vision, Nausea, vomiting, constipation or diarrhea, Chest pain, Involuntary trembling, Pain in the lower chest or upper abdomen, Increased appetite, Weight loss, Excessive thirst and urination, Insomnia, Tingling, burning or numbness in the legs and feet, Shortness of breath, Muscle weakness, Anxiety, Trouble coping with high temperature.

• #2 Get Pheochromocytoma Treatment Online

  https://www.telemed2u.com/diabetes-endocrinology/pheochromocytoma

  Pheochromocytoma is most often diagnosed in individuals between the ages of 20-50. They usually have one or more of the following signs or symptoms: High blood pressure, Headaches, Excessive sweating, Rapid or irregular heartbeat, Shortness of breath, Tremors, Pallor, or loss of color in the face, Panic attacks or increased anxiety symptoms. […] Symptoms may be constant or can be triggered and/or made worse by the following: Physical or emotional stress including physical exertion, surgery, or labor and delivery, Eating foods that are high in tyramine content, such as foods that are fermented, rancid, cured, or preserved. These include some cheeses, beers or wines, chocolate, and dried or smoked meats. […] Drugs or medications: Stimulants, like amphetamines or cocaine, Antidepressants like Amitriptyline, Doxepin, or Imipramine, Anesthesia, Beta-blockers.

• #2 Pheochromocytoma Causes, Symptoms, and Treatments | UPMC

  https://www.upmc.com/services/endocrinology/conditions/pheochromocytoma

  Pheochromocytoma symptoms include: […] Bad headaches. […] Chest pain. […] Excessive anxiety, worry, or nervousness. […] Excessive sweating. […] Fatigue. […] Feeling overheated. […] Heart palpitations or racing heartbeat. […] High blood pressure. […] Insomnia. […] Nausea and vomiting. […] Pallor or paleness. […] Panic attacks. […] Seizures. […] Shortness of breath. […] Stomach pain. […] Weight loss. […] People with PCC may get sudden symptoms or an „attack.” […] These sudden attacks may: […] Get longer, more severe, and closer together as the tumor grows. […] Having PCC can lead to serious health problems. […] Most PCCs aren’t cancerous. But the tumor can release hormones that cause extremely high blood pressure. […] Untreated, PCC and the resulting high blood pressure can lead to: […] Heart attack. […] Stroke. […] Death. […] If the tumor is malignant, the cancer can spread to other parts of your body.

• #2 Pheochromocytoma and Paraganglioma Symptoms and Treatment | Saint John’s Cancer Institute

  https://www.saintjohnscancer.org/endocrine/conditions/pheochromocytoma-and-paraganglioma/

  Pheochromocytoma Symptoms […] Common pheochromocytoma/PPGL symptoms may include: high blood pressure, either continuous or episodic, palpitations, headaches, and sweating. […] Some people dont have any obvious, overt symptoms of pheochromocytoma. This is called subclinical pheochromocytoma (if its an adrenal tumor). About half of all paragangliomas dont produce any obvious symptoms. […] Sometimes, symptoms may occur after a procedure or eating certain foods.

• #2 Pheochromocytoma: Risk Factors, Causes and Symptoms

  https://www.healthline.com/health/pheochromocytoma

  A sudden large increase in adrenal hormones is called an adrenergic crisis (AC). AC causes severe high blood pressure (hypertension) and a rapid heart rate (tachycardia). […] Common symptoms of PCC are: headaches, sweating, high blood pressure that may be resistant to conventional medications, rapid heart rate or palpitations, abdominal pain, irritability and anxiety, constipation. […] The presence of the first four symptoms listed above is highly suggestive of PCC. Without the presence of these four symptoms, the diagnosis can actually be excluded. […] Without treatment, those with a PCC are at a higher risk for the following conditions: high blood pressure crisis, irregular heartbeat, heart attack, multiple organs of the body begin to fail. […] The outlook for a person with a PCC depends on whether the tumor is cancerous. People who had a PCC that wasn’t cancerous had a 5-year survival rate of 96 percent. The survival rate was 44 percent for people who had a cancerous tumor.

• #2 Symptoms of Pheochromocytoma and When to See Your Doctor

  https://www.rupahealth.com/post/symptoms-of-pheochromocytoma-and-when-to-see-your-doctor

  While the prognosis of pheochromocytoma is good, untreated tumors can lead to potentially serious and life-threatening complications. An adrenergic crisis is characterized by a sudden surge of catecholamines, causing intense symptoms such as severe hypertension and arrhythmias that can cause heart attack or stroke, in addition to damage to the eyes and kidneys. […] Other complications of untreated pheochromocytoma include: cardiomyopathy (disease of the heart muscle), myocarditis (inflammation of the heart muscle), cerebral hemorrhage (bleeding in the brain), and pulmonary edema (fluid accumulation in the lungs). […] Pheochromocytoma presents with hallmark symptoms such as severe headaches, excessive sweating, rapid heart rate, and hypertension, often manifesting as episodic adrenergic crises. […] While the majority of these tumors are benign, they can lead to life-threatening complications if left untreated, including hypertensive crises and cardiovascular disease.

• #2 Understanding Pheochromocytoma Attacks and Managing Symptoms

  https://www.rupahealth.com/post/understanding-pheochromocytoma-attacks-and-managing-symptoms

  Pheochromocytoma attacks are characterized by sudden surges of catecholamines released from the tumor, leading to the rapid onset of symptoms such as palpitations and sweating. […] Left untreated, pheochromocytoma poses an increased risk for life-threatening complications. Chronic hypertension can cause damage to the arteries, heart, brain, kidneys, and eyes. It raises the risk of cardiovascular disease and life-threatening events, such as heart attack and stroke.

• #2 Phaeochromocytoma

  https://www.nhs.uk/conditions/phaeochromocytoma/

  Without treatment, phaeochromocytomas can cause severe problems and significantly affect your quality of life. […] You’ll be at risk of an irregular heartbeat (arrhythmia), heart attacks, strokes and organ failure. […] However, most tumours can be successfully removed by surgery and this will usually mean most of the symptoms disappear. […] In a small number of people, the tumour may come back. You’ll therefore need regular check-ups following surgery so that, if it does return, it can be picked up and treated as soon as possible. Contact your GP immediately if your symptoms come back.

• #2 Pheochromocytoma // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/pheochromocytoma

  High blood pressure is one of the main symptoms of a pheochromocytoma. But most people who have high blood pressure don’t have an adrenal tumor. […] A pheochromocytoma can lead to other health problems. The high blood pressure linked with a pheochromocytoma can damage organs, especially tissues of the heart and blood vessel system, brain and kidneys. This damage can cause dangerous conditions, including: Heart disease. Stroke. Kidney failure. Vision loss. […] If one healthy adrenal gland remains, it can carry out the functions usually done by two glands. Blood pressure usually returns to a healthy range after surgery.

• #2 Pheochromocytoma FAQs: Treatment & Diagnosis – Endocrine Surgery | UCLA Health

  https://www.uclahealth.org/medical-services/surgery/endocrine-surgery/conditions-treated/adrenal/adrenal-tumors/pheochromocytoma/pheochromocytoma-treatment-diagnosis

  For this reason, pheochromocytomas are regarded as quite likely the single most high risk tumor that physicians treat. Because they are essential regulators of blood pressure, catecholamines are normally released as part of a delicate balance. The fluctuating catecholamine levels seen in pheochromocytoma patients can cause organ damage from dangerously high blood pressure, leading to: Death, Heart attack, Stroke, Kidney failure. […] Untreated pheochromocytoma is frequently lethal. A small fraction of patients require further treatment for malignant pheochromocytoma after initial surgery. […] Inherited pheochromocytoma patients are much more likely to develop multiple tumors and tumors lying outside of the adrenal gland. These must be carefully detected prior to any attempt at surgery. […] The likelihood of malignant pheochromocytoma appears to depend heavily on the underlying mutation. For most sporadic pheochromocytomas, less than 10% turn out to be malignant. The highest rate of malignancy is associated with the SDHB mutation (familial pheochromocytoma/paraganglioma syndrome) which may carry malignancy rates above 50%.

• #2 Pheochromocytoma – Endocrinology Advisor

  https://www.endocrinologyadvisor.com/ddi/pheochromocytoma/

  Pheochromocytoma symptoms may include hypertension, headache, diaphoresis, panic attack-type symptoms, anxiety or sense of doom, rapid heartbeat, weight loss, tremors, shortness of breath, pallor, nausea and vomiting, blurry vision, constipation, pain in the chest or abdomen. […] Hypertension is the most common pheochromocytoma symptom and may be sustained or paroxysmal. Headaches also occur in up to 90% of patients. If a patient with hypertension presents with the three Ps pain (headache), palpitations, and perspiration pheochromocytoma should be immediately suspected by the clinician. […] Lifelong monitoring after surgery will be required to ensure that the pheochromocytoma treatment was successful, identify complications, and monitor tumor recurrence. Repeating biochemical tests should be done no sooner than 14 days after surgery. If metanephrine levels are elevated for three months after surgical resection, further imaging is indicated to look for another tumor. Although the long-term prognosis after surgery is excellent, nearly 50% of patients will remain hypertensive, and roughly 17% of tumors will recur, with approximately half of these showing signs of malignancy.

• #2 Pheochromocytoma: Symptoms, Treatment, and More

  https://www.verywellhealth.com/pheochromocytoma-overview-and-more-5196422

  In around 60% of people, these symptoms occur in paroxysms, which may occur as often as a few times a day or as seldom as every few months. High blood pressure may be present between paroxysms (chronic high blood pressure) or only occur during the episodes. […] Pheochromocytoma is one of the medical causes of a sense of impending doom, and these paroxysms can be very frightening. […] High blood pressure is the most common symptom of pheochromocytoma, and blood pressure spikes can be severe and dangerous. Other symptoms include headaches, heart palpitations, and sweating. […] The prognosis, or outcome, of pheochromocytoma can vary widely, depending on the stage (size of the tumor and how far it has spread) at diagnosis, whether the tumor is benign or malignant, and your overall health. […] For people who have localized tumors, between 7% and 17% will develop a recurrence. The five-year survival rate for metastatic pheochromocytoma or a local/regional pheochromocytoma that later recurs is 40%45%.

• #2 Paraganglioma and Pheochromocytoma | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/paraganglioma-and-pheochromocytoma

  Paragangliomas and pheochromocytomas are tumors that develop out of the neuroendocrine tissue responsible for making epinephrine. This hormone, also known as adrenaline, and other related hormones help regulate heart rate and blood pressure in response to stress. […] Pheochromocytomas (PCCs) are found specifically in the adrenal gland where adrenaline is produced. PCCs secrete epinephrine and norepinephrine hormones. PCCs and PGLs are rare and often slow growing. Most are benign but can cause problems such as high blood pressure, sweating, and headaches when they produce hormones. […] The symptoms of paraganglioma/pheochromocytoma (PCCs and PGLs) may vary from child to child and depend on where the tumor is located and whether it produces hormones. Symptoms might mimic other, more common ailments.

• #2 Pheochromocytoma in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=pheochromocytoma-in-children-90-P01971

  The most common symptom is high blood pressure, which can be very high. The high blood pressure can cause: […] Other symptoms can occur a bit differently in each child. They may include: […] The symptoms of pheochromocytoma can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis. […] Treatment is done by removing the tumor or tumors with surgery. Most people are cured with surgery. But in some people, the tumor can grow back. […] Complications can include heart damage or stroke caused by high blood pressure.

• #2 Hereditary Paraganglioma-Pheochromocytoma Syndrome | St. Jude Care & Treatment

  https://www.stjude.org/care-treatment/treatment/genetic-syndromes/hereditary-paraganglioma-pheochromocytoma.html

  Paragangliomas and pheochromocytomas can cause symptoms if they release catecholamines (hormones) into the bloodstream. These symptoms may include: […] Not all patients with hereditary paraganglioma-pheochromocytoma syndrome will have all these symptoms. […] Paragangliomas can also cause symptoms if they become large. These symptoms may include: […] The risk of developing paragangliomas and pheochromocytomas increases as people with the syndrome age. […] In many cases, paragangliomas and pheochromocytomas are not cancerous (malignant). Sometimes the tumors do become cancerous and spread to other parts of the body (metastasize). The risk varies greatly among different people with this condition.

• #2 Symptoms of Pheochromocytoma of the Adrenal Gland (Pheo)

  https://www.adrenal.com/pheochromocytoma/pheochromocytoma-symptoms

  The symptoms of pheochromocytomas are those attributable to excess adrenaline production from the adrenal gland tumor. However many patients with pheo’s may be without obvious symptoms and can be asymptomatic. The classic symptoms of pheochromocytomas (or pheos) are those symptoms that are caused by the excess adrenaline being produced within the adrenal gland tumor. The list below shows the classic symptoms, but some patients have no symptoms at times, and only have symptoms on occasion. Also, pheochromocytomas have been called the great mimicker because the symptoms of pheochromocytomas can mimic those of many other diseases. Nonetheless, the patients that do have symptoms from their pheo are often characterized by paroxysms (they have spells of symptoms), and at other times feel just fine.

• #2 Possible Pheochromocytoma – Please help with any advice | Adrenal Disorders | Forums

  https://patient.info/forums/discuss/possible-pheochromocytoma-please-help-with-any-advice-257467

  I have been suffereing acutely with the symptoms of a Pheo for almost a year, my first attack was 4 years ago. The attacks have slowly become more frequent and more dibilitating. The attacks include violent shaking, blister headache, vomitting, sneezing, heart pounding out of my chest. After an attack, I feel nauseated, weak, ache all over and have a headache that lasts for many hours. I have an attack almost every day and little exertion is now required to bring one on – sometimes getting out of bed does it. […] I have had high blood pressure for over 30 years and the pills never made any difference. […] A typical symptom of a pheo is that they don’t respond to normal blood pressure pills and a beta blocker can be fatal. […] I was then sent to a third endocrine specialist, who eventually agreed that I needed my left adrenal gland removed, as it had caused Cushing’s Syndrome.

• #2 Pheochromocytoma – National Adrenal Diseases Foundation

  https://www.nadf.us/pheochromocytoma.html

  Pheochromocytomas (PCCs) are tumors of the chromaffin cells that arise within the adrenal medulla. […] Pheochromocytomas-paragangliomas (PPGL) are biochemically-active endocrine tumors that often produce hormones called catecholamines (epinephrine and norepinephrine), causing serious health implications if left untreated. […] The diagnosis of pheochromocytoma is often delayed, impacting patients and their families. In part, these tumors can have an insidious course with non-specific symptoms, and in many cases they can be silent tumors. […] The clinical presentation varies widely from silent tumors to very aggressive tumors causing life-threatening symptoms; this variation is based on the hormonal activity status of these tumors and the type of hormone they are producing. The symptoms can be caused by the mass effect of the tumors, such as abdominal or flank pain, or by the excess catecholamine production. The most common symptoms seen are diaphoresis, palpitations, blood pressure fluctuations, and dizziness. Spikes in blood pressure can occur and can be life threatening if not treated appropriately.

• #2 Pheochromocytoma – National Adrenal Diseases Foundation

  https://www.nadf.us/pheochromocytoma.html

  Internists and endocrinologists suspect pheochromocytoma when they see unexplained symptoms suggestive of the disease. […] The first step any patient should take is establishing care at a specialized center with physicians who have treated at least a few hundred patients with these syndromes. […] After comprehensive evaluation and confirming the diagnosis, this is followed by advanced imaging studies to localize and stage the disease to establish a treatment plan and the prognosis.

• #2 Pheochromocytoma – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/hospital-medicine/pheochromocytoma-4/

  Pheochromocytomas are catecholamine-secreting neuroendocrine tumors. Patients classically present with symptoms and signs of excess catecholamines, including headache, palpitations, diaphoresis, and paroxysmal or sustained hypertension. […] Although most symptoms and signs of this disorder can be traced to excess catecholamines, the clinical presentation is actually quite variable. […] Most commonly, headaches, palpitations, and sweats (comprising the classic triad), as well as nausea and anxiety (can mimic panic attacks). […] Hypertension: Occurs in most patients but maybe continuous or paroxysmal. […] Hypertension and/or tachycardia (may be paroxysmal). […] Orthostatic hypotension (reflecting intravascular volume depletion and desensitization of catecholamine receptors). […] Pallor (due to vasoconstriction). […] Episodic flushing of the face. […] Most patients will do well with medications and surgical removal of the tumor, although there is a risk of recurrence (about 6% in 5 years).

• #2

  https://link.springer.com/article/10.1186/s40200-016-0226-x

  Pheochromocytoma is a rare disease but with high mortality if it is not being diagnosed early. […] The most prevalent signs and symptoms reported were hypertension (pooled sensitivity of 80.7 %), headache (pooled sensitivity of 60.4 %), palpitation (pooled sensitivity of 59.3 %) and diaphoresis (pooled sensitivity of 52.4 %). […] The classic triad of headache, palpitation and diaphoresis in hypertensive patients had the LR+ 6.312 (95 % CI 0.217183.217) and LR-0.139 (95 % CI 0.0590.331). Surprisingly, hypertension was not important in clinical suspicion of pheochromocytoma, and even normotension increased the probability of the disease. […] The clinical presentation varies, ranging from an adrenal incidentaloma to hypertensive crises with associated cerebrovascular or cardiac complications.

• #3 Pheochromocytoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589700/

  Pheochromocytomas clinical manifestations stem from the overproduction of catecholaminesa group of hormones and neurotransmitters essential for maintaining homeostasis and regulating the body’s response to stress. […] Clinical manifestations arise mainly from catecholamine excess, and about half of these tumors primarily produce epinephrine, while others mainly secrete norepinephrine. […] The clinical manifestations of these tumors are primarily due to the excessive secretion of catecholamines. […] In pheochromocytoma, episodes of hypertension are often paroxysmal and have been associated with symptoms such as headaches, tachycardia, and sweating. However, patients may also present with sustained resistant hypertension. […] Symptoms can also arise during surgery or anesthesia induction.

• #3 Pheochromocytoma – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/pheochromocytoma/

  Excess sympathetic nervous system stimulation in individuals with pheochromocytoma leads to episodic blood pressure crises with paroxysmal headaches, diaphoresis, heart palpitations, and pallor. […] Pheochromocytomas may also be asymptomatic or manifest with persistent hypertension. […] Clinical presentation is related to fluctuating levels of excess epinephrine, norepinephrine, and dopamine secretion, so symptoms are characterized by patterns of relapse and remitting (episodic hyperadrenergic syndrome). […] Episodic hypertension (or persistent hypertension in some cases); […] Patients can show typical clinical features (e.g., secondary hypertension) but may also be asymptomatic. […] 5 most important Problems (5 Ps) of Pheochromocytoma: increased blood Pressure, head Pain (headache), Perspiration, Palpitations, and Pallor. […] Hypertensive crises can be triggered by palpation of the tumor on abdominal exam.

• #3 Pheochromocytoma: Symptoms, Treatment, and More

  https://www.verywellhealth.com/pheochromocytoma-overview-and-more-5196422

  Pheochromocytomas secrete excess amounts of catecholamine hormones, including epinephrine (adrenaline), norepinephrine (noradrenaline), dopamine, and sometimes other peptide hormones. These hormones work to regulate functions like blood pressure, heart rate, and the immune system. The most common symptom of pheochromocytoma is high blood pressure (hypertension). In one study, almost 80% of people with pheochromocytomas had high blood pressure, and 53% had the classic triad of high blood pressure, sweating, and headaches. […] High blood pressure due to pheochromocytoma tends to be severe, and it may occur suddenly in people who do not have any risk factors for it. […] Other common symptoms occurring in 50% or more of people include: Headaches, Sweating, Palpitations, Tremor, Anxiety/nervousness.

• #3 Pheochromocytoma Diagnosis & Treatment – Cancer Therapy Advisor

  https://www.cancertherapyadvisor.com/ddi/pheochromocytoma/

  Pheochromocytoma symptoms may include: hypertension, headache, diaphoresis, panic attack-type symptoms, anxiety or sense of doom, rapid heartbeat, weight loss, tremors, shortness of breath, pallor, nausea and vomiting, blurry vision, constipation, pain in the chest or abdomen. […] Hypertension is the most common pheochromocytoma symptom and may be sustained or paroxysmal. […] Headaches also occur in up to 90% of patients. […] If a patient with hypertension presents with the three Ps – pain (headache), palpitations, and perspiration – pheochromocytoma should be immediately suspected by the clinician. […] The presentation of pheochromocytoma varies widely. Pheochromocytoma can be asymptomatic, diagnosed incidentally during imaging procedures for unrelated conditions or found on routine periodic screenings for those patients that have been identified with genetic predispositions. […] It may also present with symptomatic attacks ranging in frequency from a couple of times a month to multiple times per day. These pheochromocytoma symptoms occur due to the excessive release of catecholamines (such as norepinephrine and epinephrine).

• #3 Pheochromocytoma – Wikipedia

  https://en.wikipedia.org/wiki/Pheochromocytoma

  Other clinical manifestations that have been reported include (in no particular order): Pallor, Heat intolerance, Weight loss, Chest and/or abdominal discomfort, Palpitations, Nausea/vomiting, Constipation, Orthostatic hypotension becoming light-headed or dizzy after swiftly changing positions, Psychiatric manifestations: Anxiety, panic attacks, nervousness, tremors, Hyperglycemia (high blood sugar). […] While the symptoms of a pheochromocytoma are quite common, the disease has been referred to as „the great mimic”. It is estimated that approximately 0.1% of patients with hypertension have a pheochromocytoma, and it is often misdiagnosed as essential hypertension. As symptoms are often paroxysmal (episodic/sporadic), patients may not immediately seek treatment as the problem „disappears on its own.” Furthermore, when pictured in the ideal clinical scenario (an older woman in her mid-50s), the spontaneous attacks of flushing, sweating, and a racing heart may be mistaken for pre-menopausal related hot flashes. Unmanaged pheochromocytoma is dangerous and can lead to serious, potentially fatal, complications, including stroke and hypertension-induced organ damage. The cardiovascular system is the most commonly involved.

• #3 Symptoms of Pheochromocytoma of the Adrenal Gland (Pheo)

  https://www.adrenal.com/pheochromocytoma/pheochromocytoma-symptoms

  The symptoms of pheochromocytomas are those attributable to excess adrenaline production from the adrenal gland tumor. However many patients with pheo’s may be without obvious symptoms and can be asymptomatic. The classic symptoms of pheochromocytomas (or pheos) are those symptoms that are caused by the excess adrenaline being produced within the adrenal gland tumor. The list below shows the classic symptoms, but some patients have no symptoms at times, and only have symptoms on occasion. Also, pheochromocytomas have been called the great mimicker because the symptoms of pheochromocytomas can mimic those of many other diseases. Nonetheless, the patients that do have symptoms from their pheo are often characterized by paroxysms (they have spells of symptoms), and at other times feel just fine.

• #3 Understanding Pheochromocytoma Attacks and Managing Symptoms

  https://www.rupahealth.com/post/understanding-pheochromocytoma-attacks-and-managing-symptoms

  Pheochromocytoma is a rare type of tumor that forms in the adrenal glands, small triangular-shaped glands located on top of each kidney. […] The most common symptom of pheochromocytoma is high blood pressure (hypertension). More than 60% of people with pheochromocytoma have constant or episodic hypertension, which is often difficult to control and resistant to treatment. […] A pheochromocytoma attack can cause a hypertensive crisis, which is when blood pressure reaches dangerously high levels (180/120 mmHg or higher), significantly increasing the risk of organ damage and related symptoms, such as: […] Other symptoms that patients can experience during an attack include: […] The frequency and severity of pheochromocytomas vary between cases and are often related to tumor size. Some tumors do not make extra adrenaline or noradrenaline, and patients will not experience any symptoms. Others may experience attacks that occur once a month to several times a day.

• #3 Phaeochromocytoma | Adrenal gland cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/adrenal-gland-cancer/phaeochromocytoma/about

  Phaeochromocytomas can make too much of these hormones. This can cause symptoms including sweating, headaches and high blood pressure. […] You might make too much of these hormones if you have a phaeochromocytoma. An increase of adrenaline and noradrenaline can cause the following symptoms: feeling your heart thumping in your chest (palpitations), headaches, sweating, high blood pressure, anxiety or panic attacks, looking very pale, feeling weak. […] These symptoms might come on in specific attacks. Mostly they last less than 15 minutes, but they can last up to an hour. You usually feel very weak afterwards. The attacks become more frequent as time goes by.

• #3 Pheochromocytoma | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/pheochromocytoma?content_id=CON-20245736

  A pheochromocytoma can cause large changes in blood pressure. […] With a pheochromocytoma, the tumor releases hormones that can cause various symptoms. They include high blood pressure, headache, sweating and symptoms of a panic attack. If a pheochromocytoma isn’t treated, serious or life-threatening damage to other body systems can happen. […] A pheochromocytoma often causes the following symptoms: High blood pressure. Headache. Heavy sweating. Rapid heartbeat. […] Some people with pheochromocytomas also have symptoms such as: Nervous shaking. Skin that turns a lighter color, also called pallor. Shortness of breath. Panic attack-type symptoms, which can include sudden intense fear. Anxiety or a sense of doom. Vision problems. Constipation. Weight loss. […] Most often, the symptoms of pheochromocytoma come and go. When they start suddenly and keep coming back, they’re known as spells or attacks.

• #3 Pheochromocytoma: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000340.htm

  Pheochromocytoma is a rare tumor of adrenal gland tissue that typically arises from the adrenal gland. It results in the release of too much epinephrine and norepinephrine, which are hormones that control heart rate, metabolism, and blood pressure. […] Most people with this tumor have attacks of a set of symptoms, which happen when the tumor releases hormones. The attacks usually last from a few minutes to hours. The set of symptoms include: Headaches, Heart palpitations, Sweating, High blood pressure. As the tumor grows, the attacks often increase in frequency, length, and severity. […] Other symptoms that may occur include: Abdominal or chest pain, Irritability, nervousness, Pallor, Weight loss, Nausea and vomiting, Shortness of breath, Seizures, Problems sleeping.

• #3 Pheochromocytoma – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/adrenal-disorders/pheochromocytoma

  Hypertension, which is paroxysmal in 45% of patients, occurs in most patients with pheochromocytomas and is prominent. […] Common symptoms and signs are Tachycardia, Diaphoresis, Postural hypotension, Tachypnea, Cold and clammy skin, Severe headache, Angina, Palpitations, Nausea and vomiting, Epigastric pain, Visual disturbances, Dyspnea, Paresthesias, Constipation, A sense of impending doom. […] Paroxysmal attacks may be provoked by palpation of the tumor, postural changes, abdominal compression or massage, induction of anesthesia, emotional trauma, unopposed beta-blockade, or micturition. […] In older patients, severe weight loss with persistent hypertension is suggestive of pheochromocytoma. […] Physical examination, except for the presence of hypertension, is usually normal unless done during a paroxysmal attack. […] However, cardiac and cerebrovascular events are more frequent in patients with pheochromocytomas than in others with similar blood pressure levels.

• #3 Pheochromocytoma – UF Health

  https://ufhealth.org/conditions-and-treatments/pheochromocytoma

  Most people with this tumor have attacks of a set of symptoms, which happen when the tumor releases hormones. The attacks usually last from a few minutes to hours. The set of symptoms include: […] As the tumor grows, the attacks often increase in frequency, length, and severity. […] Other symptoms that may occur include: Abdominal or chest pain, irritability, nervousness, pallor, weight loss, nausea and vomiting, shortness of breath, seizures, problems sleeping.

• #3 Pheochromocytoma: What is a Pheochromocytoma? – Endocrine Surgery | UCLA Health

  https://www.uclahealth.org/medical-services/surgery/endocrine-surgery/conditions-treated/adrenal/adrenal-tumors/pheochromocytoma

  Pheochromocytoma Symptoms […] Severe headaches […] Palpitations […] Rapid heart rate […] Sweating […] Flushing […] Chest pain […] Abdominal pain […] Nervousness […] Irritability […] The most common symptom of pheochromocytoma is hypertension (high blood pressure). Patients can have persistent/chronic high blood pressure, or high blood pressure only during episodes/attacks. A common clinical feature of pheochromocytomas is an attack of symptoms (listed above) that may be frequent but occur at irregular intervals (sporadic). These attacks may worsen in severity, duration and frequency as the tumor grows. Some patients have attacks brought on by physical or emotional stress, while others are awakened from sleep with symptoms.

• #3 Pheochromocytoma – Wikipedia

  https://en.wikipedia.org/wiki/Pheochromocytoma

  In pregnancy, pheochromocytoma is associated with significant maternal and fetal mortality, mainly due to hypertensive crisis in the mother and intrauterine growth restriction in the fetus. […] Misdiagnosis of pheochromocytoma can be deadly, as beta-blockers, often prescribed for hypertension, can lead to unopposed alpha in the context of pheochromocytoma. Most mortality associated with diagnosed pheochromocytoma came from surgery and hypertensive crisis, but mortality has greatly improved. […] Hypertensive crisis: Pheochromocytoma-related hypertensive emergencies are one of the most feared clinical manifestations. Attacks are random and may occur secondary to a trigger (see Signs and Symptoms above) or spontaneously after a catecholamine surge. The prevailing symptom is elevated systolic blood pressure (200 mmHg) that is unresponsive to traditional treatment regimens and threatens end-organ damage. Patients require immediate, life-saving treatment to prevent further damage to other organs and/or death.

• #3 Pheochromocytoma | Columbia Surgery

  https://columbiasurgery.org/conditions-and-treatments/pheochromocytoma

  Patients with pheochromocytoma typically present either with classic symptoms (40%), with an incidental finding (40%), in pheo crisis (10%), or during evaluation of familial disease (10%). […] The classic symptoms of pheochromocytoma include: high blood pressure, rapid heart rate (palpitations), headache, flushing, and sweating. In addition, patients may feel like they are having an anxiety or panic attack (difficulty breathing, weakness, a feeling that something „bad” is happening). Other less common symptoms may include pale skin, blurred vision, weight loss, constipation, abdominal pain, high blood sugar levels, low blood pressure, and psychiatric disturbances. […] High blood pressure (i.e. hypertension) is the most common symptom related to pheochromocytoma, but in 10% of patients, the blood pressure may be normal. The blood pressure may always be high or may happen in bursts (i.e. episodic hypertension). […] Patients in pheo crisis have had a massive release of adrenaline that causes major health problems including stroke, heart attack, heart failure, multiple organ failure, coma, and even death. These patients often require admission to an intensive care unit.

• #3 Pheochromocytoma | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/pheochromocytoma?content_id=CON-20245736

  High blood pressure is one of the main symptoms of a pheochromocytoma. […] A pheochromocytoma can lead to other health problems. The high blood pressure linked with a pheochromocytoma can damage organs, especially tissues of the heart and blood vessel system, brain and kidneys. […] Blood pressure usually returns to a healthy range after surgery.

• #3 Adrenal Pheochromocytoma – What You Need to Know

  https://www.drugs.com/cg/adrenal-pheochromocytoma.html

  The most common sign is sudden and repeated attacks of high blood pressure. The high blood pressure can cause a severe headache and increase your heart rate, palpitations, and sweating. These attacks may occur every day or every few months. You may also have any of the following: […] Without treatment, your blood pressure may rise to dangerous levels. This may lead to life-threatening medical problems, such as heart failure or stroke. A malignant adrenal pheochromocytoma can spread to other parts of your body. Once cancer spreads, it becomes more difficult to treat. The earlier an adrenal pheochromocytoma is treated, the better your chances that serious medical problems may be prevented.

• #3 Orbital Pheochromocytoma – EyeWiki

  https://eyewiki.org/Orbital_Pheochromocytoma

  Patients with benign disease should experience an overall survival rate similar to that of the general population. However, approximately 6% to 17% of individuals with benign disease will have recurrence usually within 5-15 years after initial surgery. Approximately 15-25% of patients with recurrence develop metastatic disease. The 5-year survival in patients with metastatic disease ranges from 50% to 70%. Carriers of SDHB variants have an increased risk of developing metastatic disease of roughly 25% to 50%.

• #3 Pheochromocytoma: Risk Factors, Causes and Symptoms

  https://www.healthline.com/health/pheochromocytoma

  A sudden large increase in adrenal hormones is called an adrenergic crisis (AC). AC causes severe high blood pressure (hypertension) and a rapid heart rate (tachycardia). […] Common symptoms of PCC are: headaches, sweating, high blood pressure that may be resistant to conventional medications, rapid heart rate or palpitations, abdominal pain, irritability and anxiety, constipation. […] The presence of the first four symptoms listed above is highly suggestive of PCC. Without the presence of these four symptoms, the diagnosis can actually be excluded. […] Without treatment, those with a PCC are at a higher risk for the following conditions: high blood pressure crisis, irregular heartbeat, heart attack, multiple organs of the body begin to fail. […] The outlook for a person with a PCC depends on whether the tumor is cancerous. People who had a PCC that wasn’t cancerous had a 5-year survival rate of 96 percent. The survival rate was 44 percent for people who had a cancerous tumor.

• #3 Orbital Pheochromocytoma – EyeWiki

  https://eyewiki.org/Orbital_Pheochromocytoma

  Associated signs and symptoms include: Orbital edema, Appearance of Bulging eyes, Ophthalmoplegia, Blurry vision, Double vision, Facial numbness, Throbbing headache, Diaphoresis, Heart palpitations, Abdominal pain, Nausea, Anxiety, Tremor, Weight loss due to increased metabolism, Pallor. […] In some cases, patients may be asymptomatic and are only detected due to abnormal biochemical testing, or incidental findings on imaging. These cases are more common in patients with hereditary conditions and are found during routine testing. […] Surgical removal is the mainstay of treatment. Patients with benign pheochromocytomas and paragangliomas have an equal survival rate when compared with the general population after resection. However, malignant pheochromocytomas and paragangliomas have a 5-year survival rate of 50% compared to age-matched controls.

• #3 Pheochromocytoma-related Headache and Symptoms that Should Not be Overlooked: A Case Report

  https://www.j-nn.org/journal/view.php?number=177

  Pheochromocytoma is a rare tumor that originates from catecholamine-secreting chromaffin cells derived from the ectodermic neural system and is mostly situated in the adrenal medulla. The annual incidence of pheochromocytoma is approximately 0.8 per 100,000 person-years. A triad of symptoms of paroxysmal headache, excessive sweating, and heart palpitations should raise suspicion of pheochromocytoma, especially when concurrent hypertension exists; however, less than 25% of patients with pheochromocytoma present all three. Usually, headaches due to pheochromocytoma occur simultaneously with an abrupt increase in blood pressure. […] In this case, because no abnormalities in whole brain work-ups were found, the headache was treated with medicine as a primary headache; if the pheochromocytoma was not found, it could have caused other serious complications. Because of this, even if all neurological disease is excluded by brain work-up, other causes that can cause severe headaches should not be overlooked.

• #3 Comprehensive Pheochromocytoma Screening: Tests and Diagnosis – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/comprehensive-pheochromocytoma-screening-tests-and-diagnosis/

  Pheochromocytomas can cause an overproduction of hormones, leading to symptoms such as high blood pressure, a rapid heartbeat, and intense headaches. […] Screening is often suggested for individuals experiencing symptoms of pheochromocytoma, such as persistent high blood pressure, excessive sweating, heart palpitations, or severe headaches. […] Pheochromocytoma is a rare tumor that forms in the adrenal glands, located above the kidneys. These tumors produce excessive catecholamines, such as adrenaline and noradrenaline, which can lead to symptoms like high blood pressure, a rapid heart rate, and excessive sweating. […] Elevated hormone levels: High levels of catecholamines or metanephrines may indicate a pheochromocytoma or another adrenal gland disorder. […] In addition to physical symptoms, pheochromocytomas can cause hormonal imbalances, leading to issues such as anxiety, weight loss, or fatigue. […] Early detection through screening enables timely intervention, reducing the risk of complications such as severe hypertension, heart attack, or stroke.

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