Secondary Hypertension

~10% of cases of hypertension are secondary to another disease process (1). Secondary hypertension should be evaluated in young patients with otherwise-unexplained hypertension or patients with difficult-to-control hypertension. The most common etiologies are: Hyperthyroidism Hyperaldosteronism Hypercalcemia Obstructive Sleep Apnea Renovascular Hypertension Chronic Kidney Disease Coarctation of the Aorta Cushing Syndrome PheoChromocytoma One mnemonic to rememberContinue reading “Secondary Hypertension”

Chest Pain

Can’t Miss – Think about these etiologies first (quickly lethal) Myocardial Infarction Pulmonary Embolism Pneumothorax Aortic dissection Esophageal perforation A quick, focused history helps: Do they have typical (see ACS) anginal pain? Do they have risk factors for myocardial infarction? Have they ever had blood clots before? A history of recent immobility? Do they haveContinue reading “Chest Pain”

Shock

Shock is defined as circulatory failure resulting in systemic hypoperfusion. Most commonly as a result of low blood pressure. Approach to the hypotensive patient 4 factors play a role in hypotension (see figure below) Preload Cardiac Contractility Heart Rate Systemic Vascular Resistance Low Preload Poor volume intake Treatment: Volume resuscitation Volume loss Diarrhea Diuretics HemorrhageContinue reading “Shock”