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Case Presentation: Hypertension: Anish Dhakal (Aryan)
Case Presentation: Hypertension: Anish Dhakal (Aryan)
Hypertension
P R E PA R E D BY:
ANISH DHAKAL
(ARYAN)
Introduction
Mrs. M. T., a 70 years old female from Gorkha presented to
Gorkha hospital Emergency Department with complaints of
severe headache since morning
The headache was sudden in onset, intermittent in nature, dull
aching in character and 7/10 on visual analogue scale rating for
severity
No history of trauma, vomiting, photophobia, neck stiffness,
rash, visual symptoms, alcohol intoxication
No blurring of vision, no chest pain or heaviness, no
shortness of breath
No history of ischemic heart disease, stroke or chronic
kidney disease
Past history of COPD for 4 years (mMRC grade 2), HTN for 4
years. No other chronic illness. No surgical procedures
performed. Not under any medication at present. No
significant family history.
Risk Factors suggesting Serious Illness:
Age (70 years in the case)
Smoking (15 pack years)
Alcohol ( 1-2 glass locally made for last 50 years)
Salt intake (She loved salty foods and often added salt in pulse or/and curry)
Obesity (BMI was 24.03)
History of trauma
Systemic signs (fever, rash, stiff neck)
“Worst headache of my life” or change in frequency and severity
Known status of malignancy, HIV, immunosuppression
Focal neurological deficits
Diabetes mellitus
Examination:
GC: Fair, Moderately built
Vitals:
BP: 160/110 mm Hg (right) and 130/90 (left)
RR: 28 bpm
Pulse: 90 bpm, regular, normal volume, character, arterial wall
condition with no radioradial or radiofemoral delay
sP02: 93% in room air
Respiratory Examination:
Inspection: No visible deformity, scar marks, dilated veins,
No use of accessory muscles of respiration
Palpation: No tenderness, abnormal mass. Position of trachea
normal.
Percussion: Resonant note
Auscultation: B/L equal air entry with no added sounds
Cardiovascular examination:
S1, S2, M0
No raised JVP, apical impulse normal, no crepitation or swelling of
extremities
CNS Examination: