Differential Diagnosis for 77YO Female with Headache and Blood Pressure 195/82
- Single most likely diagnosis:
- Hypertensive urgency or emergency: The patient's elevated blood pressure (195/82) is a significant concern, and the presence of a headache could be indicative of hypertensive encephalopathy or a headache secondary to the high blood pressure.
- Other Likely diagnoses:
- Tension headache: Although the blood pressure is high, tension headaches are common and could be a contributing factor to the patient's symptoms.
- Migraine: Migraines can be triggered by various factors, including stress and hypertension, and could be a possible cause of the patient's headache.
- Uncontrolled hypertension: The patient's blood pressure is significantly elevated, suggesting uncontrolled hypertension, which could be contributing to the headache.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Subarachnoid hemorrhage: Although less likely, a subarachnoid hemorrhage (bleeding in the brain) could present with a sudden, severe headache and elevated blood pressure.
- Stroke or transient ischemic attack (TIA): The patient's age and elevated blood pressure increase the risk of stroke or TIA, which could cause a headache and other neurological symptoms.
- Pheochromocytoma: A rare tumor that can cause episodic hypertension and headaches, although it is less likely, it is crucial not to miss this diagnosis.
- Rare diagnoses:
- Temporal arteritis: An inflammatory condition that can cause headaches, although it is less common, it should be considered in older adults.
- Secondary hypertension due to renal artery stenosis or other causes: Although less likely, secondary hypertension due to underlying conditions such as renal artery stenosis could be contributing to the patient's elevated blood pressure and headache.