Malignant hypertension
Description
Malignant hypertension is the most sevaere form of hypertension and is charaacterized by extremely high blood pressure that is elevated suddenly and, in some cases, may be associated with end-organ damage. There are two types of malignant hypertension; hypertensive emergency which is associated with end-organ damage, and hypertensive urgency which is not associated with end-organ damage. This can happen in people with or without a history of hypertension.
Symptoms
- Chest pain
- Shortness of breath
- Headache
- Neurological impairment
- Visual impairment
- Confusion
- Nausea
- Vomiting
- Fainting or near fainting
- Abdominal pain
- Bleeding from the nose
Go to the hospital if you have any of these symptoms, then follow up with a Cardiologist afterwards
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View MoreCauses
- Non-adherence to high blood pressure medications
- Inadequate therapy
- Endocrine disease
- Kidney disease
- Pregnancy
- Drug toxicity
- Central nervous system disorders (ex: Head injury, brain bleeding, stroke)
Diagnostics
In addition to elevated blood pressure, different tests should be done to determine if organ damage has occurred.
- Electrocardiogram to check if the presence of irregular heartbeats
- Chest x-ray to detect the presence of fluids in the lungs
- Urinalysis to examine the kidney and liver functions
- Cardiac enzymes if a heart attack is suspected
- Toxicology screening to identify the types of medications in the blood
- Scans (CT/MRI) to examine the brain and the eye
Treatment
In emergency cases admitted to the hospital, blood pressure should be reduced gradually to avoid organ damage, the medications are chosen according to the case, but in emergency cases, intravenous medications are used followed by oral medications.
- Intravenous medications: Labetalol, Nicardipine, Nitroprusside, Urapidil.
- Oral medications: Captopril, Ramipril, Enalapril, Azilsartan, Valsartan, Losartan potassium.
