Possible catecholamine excess

This is a relatively young patient presenting with severe hypertension. He has several additional findings that are consistent with catecholamine excess:
  1. A rapid heart rate
  2. Narrowing of the vessels of the optic fundi (indicative of vasoconstriction)
  3. A significant drop in blood pressure (but remaining hypertensive) on standing
Catecholamine-mediated vasoconstriction is one of the mechanisms that helps maintain blood pressure on standing. This patient may be so vasoconstricted at rest that the circulatory system has trouble compensating for changes in position, thus the blood pressure drops when he stands up.

Additionally, the patient reports periodic episodes that suggest bursts of catecholamine release. In a patient of this age with this history, a catecholamine-producing tumor is a serious consideration.

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