THE PITFALL OF RELYING ON A SPHYGMOMANOMETER DURING A HYPERTENSIVE CRISIS

Authors

  • Toh Leong Tan Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
  • Chuan Hun Ding Department of Medical Microbiology and Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. http://orcid.org/0000-0001-6040-219X

DOI:

https://doi.org/10.22159/ajpcr.2019.v12i1.30272

Keywords:

Arterial catheter, Hypertensive crisis, Hypertensive emergency, Sphygmomanometer

Abstract

Hypertensive crises can be life-threatening if undiagnosed due to the risk of acute target organ damage. This is a case of a middle-aged woman with poorly controlled hypertension who presented with a 3-day history of dyspnea, orthopnea, and cough productive of frothy sputum. Repeated attempts to measure her blood pressure (BP) using both a mercury and an electronic sphygmomanometer were unsuccessful. However, when an arterial catheterization of the right radial artery was performed, her mean BP was 358/151 mm Hg. A chest X-ray revealed cardiomegaly with plethoric lung fields. Following a diagnosis of hypertensive emergency with acute pulmonary edema, a glyceryl trinitrate infusion at a dose of 20 mg/min was commenced and titrated in an escalating manner. She was also given a single dose of intravenous frusemide 40 mg. Her BP was successfully reduced by 25% within 3 h of presentation.

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Published

07-01-2019

How to Cite

Tan, T. L., and C. H. Ding. “THE PITFALL OF RELYING ON A SPHYGMOMANOMETER DURING A HYPERTENSIVE CRISIS”. Asian Journal of Pharmaceutical and Clinical Research, vol. 12, no. 1, Jan. 2019, pp. 9-10, doi:10.22159/ajpcr.2019.v12i1.30272.

Issue

Section

Case Study(s)