Overview
Introduction
The NP's first task is not to diagnose pheochromocytoma from one symptom or one blood pressure reading.
The NP's first task is not to diagnose pheochromocytoma from one symptom or one blood-pressure reading. It is to recognize when ordinary hypertension no longer explains the pattern. Abrupt spells of headache, palpitations, diaphoresis, pallor, and marked blood-pressure elevation may reflect catecholamine release; another patient may have sustained hypertension or a crisis during anaesthesia, surgery, micturition, abdominal-pressure changes, or exposure to a provoking medication. Confirm suspected disease biochemically before ordering localization imaging. A correctly collected test, medication review, and timely referral are safer than chasing an incidental adrenal finding or treating the presentation as uncomplicated essential hypertension. In Canada, a strongly suspected or biochemically positive case should be coordinated with endocrinology or a specialized hypertension centre. The critical prescribing sequence is alpha blockade first; beta blockade comes later, if needed for tachycardia or arrhythmia.