CVS Case 3
A 60 yr old man was brought to the A&E department complaining of severe headache and vomiting. Family members also complained that he had been acting “strangely” over the past 24 h. He was told by doctors some years back that he had hypertension and required treatment but he opted to self-medicate with herbals. He also had a long history of poorly controlled diabetes and hypercholesterolemia. Examination showed the patient in distress. Pulse rate was 100 per min and BP was 230/100. Examination of the optic fundus showed retinal hemorrhages and papilloedema. The heart was enlarged and crepitations were heard on auscultation of the lungs. He was immediately treated with a number of drugs to lower blood pressure. Subsequent arteriography showed renal artery stenosis.
- Define normal limits of blood pressure
- What is the underlying problem in the patient?
- Explain why the heart is enlarged in hypertension
- Explain how an enlargement of the heart can lead to heart failure
- Explain how “crepitations” occurred in the patient
- Explain the auto-regulation of blood flow to the brain and how it may have changed in the patient
- Explain the presence of retinal hemorrhages and papilloedema in the patient.