[25 years' experience with diagnosis of pheochromocytoma]

The author submits his 25-year experience with the diagnosis of pheochromocytoma in 36 patients. He evaluates the clinical picture by discrimination analysis of subjective symptoms and objective signs of the disease. Hypertension--by 24-hour monitoring of the blood pressure. In case of slight elevation of catecholamines he uses the Estulice test. In liminal cases patients are dispensarised. Due to a higher frequency of CT examinations in hypertonic patients findings of adenomas of the adrenals cumulate which are hormonally inactive. Gammagraphy can in that case confirm a functionally active pheochromocytoma, it can however produce also a falsely positive finding with an extraadrenal localization. Non-invasive detection of the site of a pheochromocytoma (computed tomography, ultrasonography, metaiodobenzyl guanidine gammagraphy, the finding of an increased catecholamine production) suffices for indication of surgical treatment. The author tries to avoid invasive examinations (angiography), as well as pharmacological provocation tests. Symptoms of catecholamine heart muscle disease can simulate the electrocardiographic finding of acute myocardial infarction which makes decision taking on the therapeutic procedure more difficult. After alpha-blockers and in particular after a successful operation the electrocardiographic changes are restored to normal. After early assessment of the diagnosis and surgery the disease has at present a favourable prognosis.