A Case Study: Hypertensive Emergency Secondary to Complications and Non-Compliance

摘要

Introduction: Myocardial injury is one of the most notorious complications of a hypertensive emergency. Electrocardiogram signs are used to detect level of cardiac injury and related effect on other organ. Lack of early signs to predict end-organ damage might lead to a delay in the initiation of therapy and selection of the incorrect therapeutic strategy. Case presentation: A 50 year-old Malay lady presented with left-sided body weakness associated with numbness of her left upper limb. She was diagnosed for hypertensive emergency evidenced by elevated blood pressure measurement 215/109 mmHg. Electrocardiogram indicated T-wave inversion and echo revealed concentric left ventricular hypertrophy, trivial tricuspid regurgitation and diastolic dysfunction. Her brain computed tomography scans indicated right middle cerebral artery territory infarction related to the left hemiparesis. Conclusion: Hypertension crisis result in increased mortality. Frequent monitoring, timely recognition and treatment are essential in preventing organ damage. Intensive care unit is necessary to achieve appropriate therapeutic endpoints. Individualizing treatment protocol must be developed according to the presence of specific target organ damage and underlying comorbidities. Extensive counseling should be provided to avoid hypertensive emergency.