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Medical Emergency - Phaechromocytoma can cause a hypertensive crisis, and needs dealing with promptly!

What is it?

It's an adrenal tumour that secretes loads of catacholamines - adrenaline and noradrenaline. This is bad because they act as vasoconstrictors, giving you ridiculously high blood pressure and tachycardia.

How does it present?

You would then do a test of catecholamine levels in the blood or in a 24h urine. (Phaeo can cause sporadic increases.)

How is it treated?

  1. The first thing to do is give Phentolamine 25mg IV. This is a vasodilator, and counteracts the outrageous blood pressure.
  2. The normal next step is surgery, to remove the lump. Around 10% of phaechromocytomas are malignant, but the majority are easily removed via surgery, however the fact that they are releasing hormones, and the patient is likely to be low on electrolytes and fluid makes it a technically difficult procedure.