Hypertensive emergency

A 55-year-old man is brought to the emergency department due to the acute onset of diffuse headache, blurry vision, and nausea that started 2 hours ago. His partner states that the patient has not visited a physician in several years. Medical history is significant for type 2 diabetes mellitus, hypertension and smoking 1 pack of cigarettes daily for 30 years. Temperature is 37.7°C (99.8°F), pulse is 90/min, respirations are 20/min, and blood pressure is 189/130 mmHg. On physical examination, the patient is confused and dyspneic. No neck pain or stiffness is noted. Lung auscultation reveals bilateral crackles without wheezing. Fundoscopic examination reveals bilateral blurring of the optic disc margins. The rest of the physical examination is within normal limits. Which of the following is the most likely diagnosis?

Key Takeaways

Hypertensive emergency refers to a spike in blood pressure to dangerously high levels, specifically above 180/120 mm Hg, associated with signs of acute end-organ damage. Signs of end-organ damage may include severe headache, blurred vision, nosebleeds, vomiting, cardiac symptoms, hematuria, etc. This is an emergency because it can damage the heart, brain, and other vital organs. Hypertensive emergencies should be treated quickly and carefully to prevent complications including sudden death.

Hypertensive emergency

Videos

Notes

Hypertensive emergency

Congenital disorders

Diseases of the myocardium

Diseases of the pericardium

Dyslipidemia

Dysrhythmias

Hypertension

Hypotension

Infectious, immunologic, and inflammatory disorders

Ischemic heart disease

Neoplasms

Shock

Valvular heart disease

Vascular disorders

Cardiovascular system pathology review

Questions

USMLE® Step 1 style questions USMLE

Key Takeaways

Ask Osmosis AI

Try the full Osmosis experience

Questions

USMLE® Step 1 style questions USMLE