Signs and Symptoms

Question 1

What are the symptoms of a hypertensive emergency?

Answer 1

• Chest pain
• SOB
• Back pain
• Numbness/weakness
• Vision change
• Difficulty speaking

Question 2

How does primary hyperaldosteronism present?

Answer 2

• Hypokalaemia - muscle weakness, cramping, palpitations
• Hypokalaemia induced nephrogenic DI: polyuria and polydipsia
• Complications of long-standing hypertension

Question 3

What end-organ damage occurs in the eyes due to hypertension?

Answer 3

Flame haemorrhage, hard exudates, cotton wool spot, papilloedema

Question 4

What end-organ damage occurs in the heart due to hypertension?

Answer 4

Left ventricular hypertrophy, IHD with or without heart failure

Question 5

What are the signs of malignant or accelerated phase hypertension?

Answer 5

• Systolic >200, diastolic >130mmHg
• Bilateral retinal haemorrhages and exudates
• Papilloedema
• Headache
• Visual disturbance
• More common in younger and black patients

Question 6

What are the findings in end-organ damage of the heart?

Answer 6

• Increased JVP
• S3 gallop rhythm
• Bibasal crackles
• Peripheral oedema

Question 7

What are the findings in end-organ damage of the brain?

Answer 7

Confusion (hypertensive encephalopathy), cerebral haemorrhage