Malignant hypertension

Malignant hypertension

Description Symptoms Causes Diagnostics Treatment

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 

Causes

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. 

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