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OCR: of the Most clinicians rely on the clinical histo patients patient to suggest the diagnosis and do n routinely measure catecholamines in all of having with hypertension. In a patient suspecte ative step isa phaeochromocytoma, the first investig to measure the urinary excretion of on is vanillylmandelic acid (VMA); the excret th elevated in ninety per cent of patients w ever, the phaeochromocytomas. Occasionally, ho es, level of VMA is normal. In such instand he urine; metanephrines should be measured in t and alternatively, and more reliably, plasma naline urinary levels of adrenaline and noradre would be meas