Management of Pheochromocytoma Crisis

Written by Chen Yu Fei
Neurosurgery
Updated on April 21, 2025
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When a pheochromocytoma crisis occurs, the patient often first shows significant elevations in blood pressure, usually characterized by a rise in systolic pressure, which can exceed 200mmHg or even 300mmHg. Immediate administration of antihypertensive drugs for symptomatic treatment is necessary. Additionally, the patient may exhibit a clear hypermetabolic state, with profuse sweating, limb convulsions, and even consciousness disorders. At this point, the patient should be immediately transferred to the intensive care unit for close observation of any changes in their condition, and effective monitoring of vital signs should be conducted. Furthermore, patients should receive cardiac monitoring, blood oxygen saturation monitoring, and can be given intravenous infusions of sodium nitroprusside to rapidly reduce blood pressure. Meanwhile, ongoing observation of the patient’s condition and appropriate replenishment of blood volume are needed. (Please administer medication under the guidance of a professional physician and do not medicate blindly.)

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Written by Chen Yu Fei
Neurosurgery
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Is pheochromocytoma a cancer?

Pheochromocytoma is not a cancer. It is a special type of tumor tissue that usually originates from the neuroectodermal chromaffin tissue. It can secrete catecholamines. Based on the specific origins of the tumor cells, it can be divided into types such as parasympathetic, paraganglioma, sympathetic, and ganglioneuroma. Most often, it presents with long-term hypertension, which can cause damage to the heart, brain, and kidneys due to prolonged hypertension, or severe increases in blood pressure can lead to hypertensive brain hemorrhage, thereby endangering the patient's life. Early treatment is often necessary.

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Written by Chen Yu Fei
Neurosurgery
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The manifestations of pheochromocytoma crisis

For patients with pheochromocytoma, during a crisis, it generally manifests as a sudden increase in the patient's blood pressure, which can rise to above 200-300 mmHg. Additionally, the patient experiences severe headaches and dizziness, severe nausea and vomiting. Some patients may experience significant discomfort and tachycardia, arrhythmias. Some patients also suffer from abdominal or chest pain, labored breathing, and difficulty breathing, and even blurred vision. In severe cases, the excessively high blood pressure can lead to hypertensive cerebral hemorrhage or other unexpected cardiovascular and cerebrovascular diseases. The patient’s vital signs are extremely unstable, often accompanied by multiple organ dysfunction or failure.

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Written by Chen Yu Fei
Neurosurgery
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What tests are used for pheochromocytoma?

For pheochromocytoma, it is usual to perform both qualitative and localization diagnoses. The qualitative diagnosis is generally based on the measurement of catecholamines and their metabolites in the patient's blood and urine. Localization diagnosis is more commonly determined through methods such as CT scans, MRI, and ultrasound to pinpoint the specific location of the pheochromocytoma, facilitating surgical treatment. Most patients achieve satisfactory results from surgery. Additionally, treatment may include the use of antihypertensive drugs. With combined treatment, most patients can achieve satisfactory results. It is recommended to seek treatment at a well-known tertiary hospital locally.

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Written by Chen Yu Fei
Neurosurgery
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Pheochromocytoma Test Items

For pheochromocytoma, the usual tests include routine blood tests, routine urine tests, and biochemical examinations. Specific tests mainly involve collecting blood and urine catecholamine metabolites to help diagnose the condition. Furthermore, further localization diagnostics are conducted on the patient via abdominal ultrasound, as well as CT or MRI scans, to determine the specific location of the pheochromocytoma growth. Further examinations are conducted in preparation for subsequent surgery, with treatment generally recommended to be surgical. During treatment, antihypertensive drugs are used in conjunction to control blood pressure and maintain stability of the condition.

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Written by Chen Yu Fei
Neurosurgery
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Can a pheochromocytoma be treated without surgery?

For pheochromocytoma, it is still best to receive surgical treatment. Conservative treatment through medication alone has limited effects. In most cases, gradually increasing blood pressure leads to serious symptoms or signs in the patient, such as palpitations, shortness of breath, labored breathing, chest pain, accompanied by profuse sweating, and even severe panic and feelings of impending doom, posing serious life-threatening risks to the patient. In terms of treatment, it is advised to prioritize surgical removal of the tumor, as this can fundamentally lead to a complete cure. Additionally, appropriate medication can be used before and after the surgery to assist in treatment.