Differential Diagnosis for 5 Week Postpartum Hypertension Following Mild Preeclampsia
- Single Most Likely Diagnosis
- Postpartum preeclampsia: This condition can persist or develop after delivery, especially in women with a history of preeclampsia during pregnancy. The fact that the patient had mild preeclampsia during pregnancy increases the likelihood of this diagnosis.
- Other Likely Diagnoses
- Chronic hypertension: The patient may have had undiagnosed chronic hypertension before pregnancy, which was unmasked by the pregnancy. The hypertension could be persisting postpartum.
- Postpartum renal disease: Conditions such as postpartum acute kidney injury or renal thrombotic microangiopathy can cause hypertension.
- Thyroid storm or postpartum thyroiditis: Although less common, thyroid disorders can cause hypertension and are more likely in the postpartum period.
- Do Not Miss Diagnoses
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause severe hypertension. Although unlikely, missing this diagnosis could be catastrophic.
- Postpartum cardiomyopathy: A condition where the heart muscle becomes weakened, leading to heart failure. Hypertension can be a presenting symptom.
- Renal artery thrombosis or stenosis: These conditions can cause severe hypertension and are important to rule out, especially if the patient has risk factors such as a history of renal disease.
- Rare Diagnoses
- Liddle syndrome: A rare genetic disorder that affects the kidneys' ability to regulate sodium and potassium, leading to hypertension.
- Hyperaldosteronism: A condition where the adrenal gland produces too much aldosterone, leading to hypertension.
- Cushing's syndrome: A rare endocrine disorder caused by excess cortisol production, which can lead to hypertension.