Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with severe elevation in blood pressure (BP >180/120 mmHg) noted on routine screening/home monitoring. Patient denies symptoms of acute end-organ damage, specifically: no chest pain, dyspnea, focal neurological deficits, visual disturbances, or severe headache. No history of recent medication non-adherence or new toxic ingestion.
Clinical Examination Findings
General: Alert and oriented x3, no acute distress. HEENT: Normocephalic, atraumatic, no papilledema on funduscopic exam. Cardiovascular: Regular rate and rhythm, S1/S2 present, no murmurs, rubs, or gallops. Pulmonary: Clear to auscultation bilaterally, no rales or wheezing. Neurological: Grossly intact, no focal deficits, gait stable. Skin: No peripheral edema.
Treatment Protocol
1. Re-check BP after 30 minutes of quiet rest. 2. Review current antihypertensive regimen and assess for medication non-adherence. 3. Initiate or adjust oral antihypertensive therapy (e.g., Amlodipine, Lisinopril, or Clonidine) as indicated. 4. Avoid rapid reduction of BP to prevent cerebral hypoperfusion. 5. Schedule close follow-up within 24-48 hours.