Differential Diagnosis for Hypertensive Emergency
- Single most likely diagnosis
- Hypertensive crisis due to uncontrolled essential hypertension: This is the most common cause of hypertensive emergency, often resulting from non-adherence to medication, inadequate treatment, or secondary causes such as renal disease.
- Other Likely diagnoses
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic or sustained hypertension due to excessive catecholamine release.
- Renal artery stenosis: Narrowing of the arteries that supply blood to the kidneys, leading to activation of the renin-angiotensin-aldosterone system and subsequent hypertension.
- Primary aldosteronism: Excess production of aldosterone, leading to sodium retention, volume expansion, and hypertension.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aortic dissection: A life-threatening condition where there is a tear in the inner layer of the aorta, which can be precipitated by severe hypertension.
- Intracranial hemorrhage: Severe hypertension can cause rupture of blood vessels in the brain, leading to potentially fatal bleeding.
- Pulmonary edema: Severe hypertension can lead to heart failure and fluid accumulation in the lungs, which can be life-threatening if not promptly treated.
- Rare diagnoses
- Cushing's syndrome: A rare endocrine disorder caused by excess cortisol production, which can lead to hypertension among other symptoms.
- Thyrotoxic crisis: A life-threatening condition caused by excessive thyroid hormone production, which can lead to severe hypertension and other systemic symptoms.
- Eclampsia: Seizures in a pregnant woman, often preceded by pre-eclampsia, which is characterized by new-onset hypertension and proteinuria during pregnancy.