Causes of hypotension in pheochromocytoma

Written by Chen Yu Fei
Neurosurgery
Updated on September 16, 2024
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For cases of hypotension occurring in pheochromocytoma, it is most commonly seen after the surgical removal of the tumor. At this point, the concentration of catecholamines in the blood may significantly decrease, leading to a marked reduction in effective circulating blood volume, and thus causing hypotension. This situation is relatively common after surgery for pheochromocytoma. Usually, after surgical treatment and removal of the tumor, it is important to promptly discontinue the use of receptor blockers in patients and to appropriately replenish blood volume to effectively maintain central venous pressure. This approach can generally counteract the reduction in catecholamine levels caused by surgery, which leads to hypotension.

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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.

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Written by Chen Yu Fei
Neurosurgery
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Causes of hypotension in pheochromocytoma

For cases of hypotension occurring in pheochromocytoma, it is most commonly seen after the surgical removal of the tumor. At this point, the concentration of catecholamines in the blood may significantly decrease, leading to a marked reduction in effective circulating blood volume, and thus causing hypotension. This situation is relatively common after surgery for pheochromocytoma. Usually, after surgical treatment and removal of the tumor, it is important to promptly discontinue the use of receptor blockers in patients and to appropriately replenish blood volume to effectively maintain central venous pressure. This approach can generally counteract the reduction in catecholamine levels caused by surgery, which leads to hypotension.

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Written by Chen Yu Fei
Neurosurgery
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Pheochromocytoma typical manifestations

For pheochromocytoma, the term usually refers to tumors arising from the chromaffin tissue of the neural crest. Clinically, the main typical symptoms include severe hypertension, along with nausea, vomiting, intense headache, and dizziness. Additionally, it may also cause the patient to be in a continuous high metabolic state, characterized by persistent hyperglycemia, nausea, vomiting, and excessive sweating. If not treated promptly and effectively, it may pose serious threats to the patient's heart, brain, and kidneys. In severe cases, it could even be life-threatening. Surgery is commonly recommended for treatment.

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Written by Chen Yu Fei
Neurosurgery
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How is pheochromocytoma diagnosed?

For patients with pheochromocytoma, comprehensive examinations are necessary for diagnosis. For instance, measuring catecholamines and their metabolites in blood or urine can help determine if there is a noticeable increase in catecholamine levels. Furthermore, adrenal CT scans can be used to assess the condition, where in many cases, significant occupying lesions can be detected through adrenal CT scans. In addition, other related tests also hold diagnostic value and significance, such as magnetic resonance imaging, ultrasound, and related nuclear scanning tests, which can assist in qualitative and locational diagnosis.

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Written by Chen Yu Fei
Neurosurgery
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What department should I go to for pheochromocytoma?

Pheochromocytoma generally requires consultation at the endocrinology or surgical department. Please ask a physician to assess the current situation. For further examination and diagnosis of pheochromocytoma, qualitative and locational diagnostics are necessary. Qualitative diagnostics typically involve blood tests where levels of catecholamine metabolites in the blood and urine are tested to assist in diagnosis; locational diagnostics involve using CT scans, MRI, and ultrasound to help determine the specific location of the tumor. Treatment for pheochromocytoma generally involves surgical removal of the tumor once it is found, combined with medication treatment, which often leads to satisfactory therapeutic outcomes.