Catecholamine hypersecretion, also known as pheochromocytoma, originates in the adrenal medulla, sympathetic ganglion, parasympathetic ganglion (paraganglia) or other sites of chromophobic tissue. Due to the paroxysmal or persistent secretion of norepinephrine and epinephrine by the tumor cells, the clinical picture is one of paroxysmal or persistent hypertension, headache, sweating, palpitations and metabolic disorders. If treated early, it can be cured. Differential diagnosis of catecholamine hypersecretion: 1. Primary hypertension Some patients with primary hypertension present with high sympathetic excitability, manifested by palpitations, excessive sweating, anxiety, and increased cardiac output. However, the patient’s urinary catecholamines are normal. In particular, urine retention to determine catecholamines during anxiety attacks is more helpful in excluding pheochromocytoma. 2. Intracranial disease When intracranial disease is combined with high cranial pressure, symptoms such as severe headache similar to pheochromocytoma can occur. Patients will usually have signs of other neurological damage to support the primary cause. However, one should also be alert to conditions such as pheochromocytoma complicated by cerebral hemorrhage. 3. Neuropsychiatric disorders Anxiety attacks, especially when accompanied by hyperventilation, are easily confused with pheochromocytoma attacks. However, blood pressure is usually normal during anxiety attacks. If blood pressure is also elevated, it is necessary to measure blood and urine catecholamines to help differentiate. Seizures also resemble pheochromocytoma, and sometimes blood catecholamines may be elevated, but urine catecholamines are normal. The presence of aura before seizure, abnormal EEG and effective anti-seizure therapy can help to exclude pheochromocytoma. 4. Menopausal syndrome Women in menopausal transition may have a variety of symptoms caused by estrogen deficiency, such as hot flashes, sweating, impatience, and uncontrollable mood swings, similar to pheochromocytoma seizures, and can be differentiated by understanding menstrual history and performing sex hormone and CA measurements. 5.Other In hyperthyroidism, hypermetabolic symptoms and hypertension are present. However, diastolic blood pressure is normal and catecholamines are not increased. Coronary angina attacks and acute myocardial infarction need to be differentiated from pheochromocytoma. They can be distinguished from pheochromocytoma based on electrocardiographic changes during the attack and the effectiveness of treatment to improve blood supply to the heart muscle. Pheochromocytoma accounts for about 0.5-1% of the causes of hypertension. 90% of patients can be cured by surgery. Because of the risk of acute accidents during the attack of this disease, and because some of them are malignant pheochromocytomas, they should be treated early. However, because patients often have intermittent attacks, which makes certain experiments and examinations difficult, the selection of examination methods should be considered.