Malignant Hypertension - What Are The Symptoms And Treatment?
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Almost all the cases of malignant hypertension occur in people, who have ignored or stopped taking medicines for high blood pressure. Malignant hypertension is mostly the result of patients not taking treatment in time for hypertension, due to which high blood pressure rises further to extremely high and life-threatening levels.
Malignant hypertension can also be a consequence of kidney failure or due to renal artery stenosis. It could also be caused as a result of complications during pregnancy, intake of cocaine, monoamine oxidase inhibitors (MAOIs), clonidine, steroids, alcohol, oral contraceptives, and the withdrawal of beta-blockers. However its chances of occurring are as low as 1 in 100 patients.
Malignant hypertension is a hypertensive emergency which is characterized by severely high systolic/diastolic pressure levels of blood. The systolic/diastolic pressure greater than 220/140 mmHg respectively is termed as severely high. The condition may also show hemorrhage in the small and large blood vessels of the eyes, the kidneys, the brain, the lungs, and the heart.
Hypertensive urgency needs to be distinguished from the above two hypertensive emergencies. In hypertensive urgency, the systolic/diastolic blood pressure level rises above 220/120 mm Hg respectively, but no evidence of any organ damage is found. Two forms of severe hypertension with organ damage are known. One is known as accelerated hypertension and the other is known as malignant hypertension. Accelerated hypertension is the milder of the two and is characterized by soft exudates, but no papilledema (swelling of the optic nerve). Both are hypertensive emergencies, with malignant hypertension being the greater of the two. Malignant hypertension is known as malignant because, if the blood pressure is not lowered immediately within minutes to hours to significantly lower levels, a person afflicted with it could even die. This would occur due to irrevocable hemorrhagic damage (and consequent aftereffects of the same) to the kidneys, eyes, lungs, heart, and the brain. Blindness or severe kidney damage culminating in kidney failure could be the consequence. The patient could suffer a heart attack resulting in heart failure. He/she may suffer a stroke or brain swelling or a hemorrhagic stroke. The signs and symptoms of malignant hypertension include severe headache, shortness of breath (dyspnea), chest pain, nausea, vomiting, blurred vision, seizures, loss of consciousness, and numbness of the arms, face, legs, face, or other areas. They also include fatigue, cough, anxiety, confusion, drowsiness, and decreased urine output. A patient who suffers from malignant hypertension needs immediate medical care. Exams and tests done during a medical check for malignant hypertension may reveal retinal bleeding, swelling of the optic nerve, or other issues with the retina. It may reveal damage to kidneys. The tests done to detect this damage would include blood urea nitrogen (BUN), serum creatinine, arterial blood gas analysis, and urinalysis. Lung congestion would show up in a chest x-ray. If malignant hypertension is present, variation would show up in the results of aldesterone, renin, and urinary cast tests. Treatment for malignant hypertension includes medication administered through a vein to reduce blood pressure to significantly low levels.
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