What are the differential diagnoses (Ddx) for a hypertensive emergency?

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Differential Diagnosis for Hypertensive Emergency

Single Most Likely Diagnosis

  • Hypertensive Heart Disease: This is the most likely diagnosis, as uncontrolled hypertension can lead to heart failure, coronary artery disease, and cardiac arrhythmias, all of which can present as a hypertensive emergency.

Other Likely Diagnoses

  • Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic hypertension, which may present as a hypertensive emergency.
  • Renal Artery Stenosis: Narrowing of the renal arteries can cause renovascular hypertension, leading to a hypertensive emergency.
  • Primary Aldosteronism: Excess production of aldosterone can cause resistant hypertension, potentially leading to a hypertensive emergency.

Do Not Miss Diagnoses

  • Aortic Dissection: A life-threatening condition where the aorta tears, which can be precipitated by severe hypertension. Missing this diagnosis can be fatal.
  • Intracranial Hemorrhage: Severe hypertension can cause bleeding in the brain, which is a medical emergency.
  • Pulmonary Edema: Fluid accumulation in the lungs due to heart failure, which can be caused by uncontrolled hypertension.
  • Eclampsia: Seizures in a pregnant woman with preeclampsia, which is a hypertensive disorder of pregnancy.

Rare Diagnoses

  • Cushing's Syndrome: A rare endocrine disorder caused by excess cortisol production, which can lead to hypertension.
  • Hyperthyroidism: Excess thyroid hormone production can cause hypertension, although it is a rare cause of hypertensive emergency.
  • Coarctation of the Aorta: A congenital narrowing of the aorta, which can cause severe hypertension, particularly in young patients.
  • Vasculitis: Inflammation of blood vessels, which can cause hypertension, although it is a rare cause of hypertensive emergency.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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