Differential Diagnosis for Elevated BP with Headache and Dizziness

Single Most Likely Diagnosis

• Hypertensive Crisis: This is the most likely diagnosis given the elevated blood pressure (167/71 mmHg) combined with symptoms of headache and dizziness. Hypertensive crisis can lead to organ damage and is a medical emergency.

Other Likely Diagnoses

• Essential Hypertension: Although the blood pressure is significantly elevated, it could be a manifestation of uncontrolled essential hypertension, especially if the patient has a history of hypertension.
• White Coat Hypertension: The elevated reading could be due to anxiety or stress in a clinical setting, which might not reflect the patient's typical blood pressure.
• Pregnancy-Induced Hypertension: If the patient is pregnant, the elevated blood pressure could be indicative of pregnancy-induced hypertension, which requires immediate attention.

Do Not Miss Diagnoses

• Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic hypertension, headaches, and dizziness. Although unlikely, missing this diagnosis could be fatal.
• Aortic Dissection: A life-threatening condition where there is a tear in the aorta's inner layer. It can present with severe hypertension and symptoms like headache and dizziness.
• Stroke or TIA (Transient Ischemic Attack): Elevated blood pressure can be both a cause and a result of stroke or TIA. Immediate diagnosis and treatment are crucial to prevent further brain damage.
• Renal Artery Stenosis: Narrowing of the arteries that supply blood to the kidneys, which can cause secondary hypertension and might present with symptoms like headache and dizziness.

Rare Diagnoses

• Hyperthyroidism: Can cause increased blood pressure, headaches, and dizziness due to the excessive production of thyroid hormones.
• Cushing's Syndrome: A rare endocrine disorder caused by excess cortisol, which can lead to hypertension, among other symptoms.
• Hyperparathyroidism: Elevated parathyroid hormone levels can lead to hypertension, but it is less commonly associated with acute symptoms like headache and dizziness.
• Coarctation of the Aorta: A congenital condition where the aorta is narrowed, which can cause high blood pressure and might present with headache and dizziness, especially if diagnosed later in life.