Malignant hypertension (patient information)

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Malignant hypertension

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Malignant hypertension?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Malignant hypertension is very high blood pressure that comes on suddenly and quickly. The lower (diastolic) blood pressure reading, which is normally around 80 mmHg, is often above 130 mmHg.

What are the symptoms of Malignant hypertension?

  • Blurred vision
  • Change in mental status
  • Anxiety
  • Confusion
  • Decreased alertness, decreased ability to concentrate
  • Fatigue
  • Restlessness
  • Sleepiness, stupor, lethargy
  • Chest pain (feeling of crushing or pressure)
  • Cough
  • Headache
  • Nausea or vomiting
  • Numbness of the arms, legs, face, or other areas
  • Reduced urine
  • Seizure
  • Shortness of breath
  • Weakness of the arms, legs, face, or other areas

What causes Malignant hypertension?

The disorder affects about 1% of people with high blood pressure, including both children and adults. It is more common in younger adults, especially African-American men.

It also occurs in people with:

  • Collagen vascular disorders
  • Kidney problems
  • Toxemia of pregnancy

You are at high risk for malignant hypertension if you have had:

  • Kidney failure
  • Renal hypertension caused by renal artery stenosis

Who is at highest risk?

Diagnosis

Malignant hypertension is a medical emergency.

A physical exam commonly shows:

Extremely high blood pressure Swelling in the lower legs and feet Abnormal heart sounds and fluid in the lungs Changes in thinking, sensation, muscle ability, and reflexes

An eye examination will reveal changes that indicate high blood pressure, including:

Bleeding of the retina Narrowing of the blood vessels in the eye area Swelling of the optic nerve Other problems with the retina

Kidney failure, as well as other complications, may develop.

Tests to determine damage to the kidneys may include:

Arterial blood gas analysis BUN Creatinine Urinalysis

A chest x-ray may show congestion in the lung and an enlarged heart.

This disease may also affect the results of the following tests:

Aldosterone level Cardiac enzymes (markers of heart damage) CT scan of the brain Electrocardiogram (EKG) Renin level Urinary sediment

When to seek urgent medical care?

Treatment options

Where to find medical care for Malignant hypertension?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

Sources

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