A 32-year-old man experiences anxiety with palpitations and is found hypertensive. What is the most likely diagnosis?

The diagnosis of pheochromocytoma is supported by the symptoms and clinical presentation described. Pheochromocytomas are tumors that arise from the adrenal gland and typically secrete catecholamines, which include epinephrine and norepinephrine. This secretion can lead to episodes of anxiety, palpitations, and hypertension, aligning well with the symptoms experienced by the patient.

The combination of anxiety, palpitations, and hypertension presents a compelling case for pheochromocytoma, particularly because these symptoms can occur in episodes, which is characteristic of catecholamine surges released by the tumor. In many cases, patients may also report paroxysmal symptoms that do not have a clear trigger, further hinting towards this diagnosis.

While hyperthyroidism can cause anxiety and palpitations due to increased metabolic activity, it usually also presents with other signs like weight loss or tremors, which are not mentioned here. Panic attacks could explain the anxiety and palpitations but are less likely to account for sustained hypertension. Cushing’s disease can lead to hypertension and various psychological symptoms, but the acute presentation matching the patient’s anxiety and episodic hypertension fits better with pheochromocytoma.

Thus, considering all aspects of the clinical presentation