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- W1988958502 abstract "Recent onset hypertension should prompt investigation for secondary causes Recent onset hypertension should prompt investigation for secondary causes. This search routinely includes screening for mineralocorticoid excess, renal artery stenosis, and, in selected cases, phaeochromocytoma. We present the case of an elderly woman with recent onset hypertension, hypokalaemia, and a raised erythrocyte sedimentation rate. The cause of the hypertension was presumed to be aortic dissection with compromised renal blood flow, but the erythrocyte sedimentation rate provided the clue to the final diagnosis.A 74 year old woman was referred because of general malaise and hypertension. During the previous months she had reported fatigue, lack of appetite and weight loss, and muscle weakness. About three weeks before admission she had had sudden onset abdominal pain and diarrhoea, for which no medical aid was sought and which subsided spontaneously after a few days. Her medical history was unremarkable. In particular, her blood pressure had been only mildly raised (160/90 mm Hg, measured repeatedly during previous years, most recently two months before admission).On examination she had severe hypertension (215/125 mm Hg) but no other abnormalities. Results of vascular, funduscopic, and abdominal examination were normal. Routine laboratory tests showed a raised erythrocyte sedimentation rate (85 mm/h), low plasma sodium (131 mmol/l) and potassium (2.8 mmol/l), moderately raised serum creatinine (111 μmol/l), and mild chronic metabolic alkalosis (arterial pH 7.51, bicarbonate 32 mmol/l). Urinary potassium concentration was 51 mmol/l, and there …" @default.
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- W1988958502 date "2008-07-04" @default.
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- W1988958502 title "Giant cell arteritis causing aortic dissection and acute hypertension" @default.
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- W1988958502 doi "https://doi.org/10.1136/bmj.39503.769225.be" @default.
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