Hypertension (main): Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Most hypertension is asymptomatic | *Most hypertension is asymptomatic | ||
*End organ damage may result in [[chest pain]], [[altered mental status]], blurred vision or signs of [[kidney failure]] | *End organ damage may result in [[chest pain]], [[altered mental status]], blurred vision or signs of [[acute kidney failure]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== |
Revision as of 11:38, 4 December 2016
Background
Categorization of Hypertension[1]
- Asymptomatic hypertension
- Systolic BP 140-179 or diastolic BP 90-109
- Asymptomatic
- Hypertensive urgency^
- Systolic BP ≥ 180 or diastolic BP ≥ 110
- No evidence of end-organ dysfunction
- Hypertensive emergency
- Systolic BP ≥ 180 or diastolic BP ≥ 110
- Evidence of end-organ dysfunction
^Many emergency physicians do not use the diagnosis of "hypertensive urgency," but utilize instead only hypertensive emergency (signs of end organ dysfunction) or asymptomatic hypertension (all others)
Clinical Features
- Most hypertension is asymptomatic
- End organ damage may result in chest pain, altered mental status, blurred vision or signs of acute kidney failure
Differential Diagnosis
Hypertension
- Hypertensive emergency
- Stroke
- Sympathetic crashing acute pulmonary edema
- Ischemic stroke
- Intracranial hemorrhage
- Preeclampsia/Eclampsia
- Autonomic dysreflexia
- Scleroderma renal crisis
- Acute glomerulonephritis
- Type- I myocardial infarction
- Volume overload
- Urinary obstruction
- Drug use or overdose (e.g stimulants, especially alcohol, cocaine, or Synthroid)
- Renal Artery Stenosis
- Nephritic and nephrotic syndrome
- Polycystic kidney disease
- Tyramine reaction
- Cushing's syndrome
- Obstructive sleep apnea
- Pheochromocytoma
- Hyperaldosteronism
- Hyperthyroidism
- Anxiety
- Pain
- Oral contraceptive use
Evaluation
Management
Disposition
- Hypertensive emergency --> admission
- Otherwise, normally discharged home with a follow up appointment with the primary care physician
References
- ↑ Levy PD. Hypertensive Emergencies — On the Cutting Edge. EMCREG - International. 2011. 19-26.