Hypertensive Crisis, Urgency and Emergency

Symptoms of the two forms of the hypertensive crisis

In hypertensive urgency, there isn’t multi-organ damage. Conversely, a hypertensive emergency occurs with multi-organ damage. Thus, the clinical presentation of both hypertensive crisis forms is different.

Hypertensive urgency may be asymptomatic, but sometimes it may occur with some symptoms such as:

  1. Headache
  2. Nausea and vomiting
  3. Epistaxis (bleeding from the nose)
  4. Dizziness
  5. Difficulty breathing
  6. Anxiety

These symptoms aren’t specific for multi-organ failure; they usually occur with any level of high blood pressure.

But the hypertensive emergency shows symptoms related to multi-organ damage, and this may end with death.

These symptoms include:

  1. Chest pain: This occurs because severe hypertension increases the load on the heart, which requires it to work with high power, in spite of lack of blood supply to its muscles.
  2. Irregular cardiac rhythm
  3. Shortness of breathing (dyspnea)
  4. Pulmonary edema and edema in other tissues
  5. Kidney damage: This results in some conditions like blood and protein in the urine, decreased urine output, and retention of waste products inside the body, which leads to toxicity and affects mental status.
  6. Headache, nausea, vomiting
  7. Confusion, loss of consciousness, seizures, anxiety, and symptoms of abnormal mental status
  8. Stroke may occur in a hypertensive emergency due to the rupture of cerebral blood vessels, which may lead to intracerebral hemorrhage.
  9. Blurred vision
  10. Preeclampsia and eclampsia in pregnant females

These are considered warning symptoms that indicate multi-organ damage and require immediate and intensive medical intervention to lower blood pressure readings and avoid further organ damage. Urgent and intensive medical care is necessary for patients in a hypertensive emergency state because they are susceptible to fatal complications that may lead to death within a short time.