22 year old male presented to the clinic with clear history of any chronic disease.... He complains of headache and blurred vision, his blood pressure was 200/120... After Lasix,ARBS, alpha blockers, Nitroglycerin and beta blockers... His systolic BP is still above 180 So what is that!! And what is the solution!?
May be renal artery stenosis : ttt by stenting or aortic stenosis
I don't think it was pheochoromocytoma... As the patient was already hypertensive... And absolutely if it was pheochoromocytoma... We should knew by just taking history
After admission I would check his renal arteries stenosis. You can tell I’m not a physician just a CMA but this is what I would do.
This patient must have fundoscopy and CT/MRI Brain along with other tests to rule out Renal Artery stenosis and pheochromocytoma and hyperaldosteronism. Detailed history ,physical examination and lab work up supported by imaging would work. My point is we should rule out raised ICP and SOL brain in young patient with resistant hypertention.
