JACC. Case reports · 2026
Extreme Malignant Hypertension Resulting in Dialysis-Dependent Hypertensive Nephrosclerosis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Al Mubaid Ahmed, Arby Muzamil, Wagmeister Sarah, Bakheshi Pooria, Sarguroh Tauseef
Аннотация
BACKGROUND: Malignant hypertension is a life-threatening condition characterized by severe blood pressure elevation with acute target-organ damage, requiring prompt but controlled management.
CASE SUMMARY: A 56-year-old woman presented with headache was found to have extreme hypertension. Despite repeated automated and manual measurements, blood pressure remained markedly elevated, prompting arterial line placement, which confirmed a blood pressure of 327/149 mm Hg. Secondary causes of hypertension were excluded. The patient was treated with intravenous nicardipine, followed by transition to maximally titrated oral antihypertensives.
DISCUSSION: Although hypertensive emergencies are well described, arterial line-confirmed blood pressures exceeding 320 mm Hg are exceedingly rare. This case highlights the importance of accurate blood pressure measurement, guideline-directed blood pressure reduction, and the devastating renal consequences of untreated hypertension.
TAKE-HOME MESSAGES: Accurate confirmation of extreme blood pressure values and controlled, guideline-directed reduction are essential to prevent ischemic complications in malignant hypertension. Successful management of malignant hypertension requires coordinated multidisciplinary care, continuous monitoring, and adherence to evidence-based blood pressure reduction strategies.
CASE SUMMARY: A 56-year-old woman presented with headache was found to have extreme hypertension. Despite repeated automated and manual measurements, blood pressure remained markedly elevated, prompting arterial line placement, which confirmed a blood pressure of 327/149 mm Hg. Secondary causes of hypertension were excluded. The patient was treated with intravenous nicardipine, followed by transition to maximally titrated oral antihypertensives.
DISCUSSION: Although hypertensive emergencies are well described, arterial line-confirmed blood pressures exceeding 320 mm Hg are exceedingly rare. This case highlights the importance of accurate blood pressure measurement, guideline-directed blood pressure reduction, and the devastating renal consequences of untreated hypertension.
TAKE-HOME MESSAGES: Accurate confirmation of extreme blood pressure values and controlled, guideline-directed reduction are essential to prevent ischemic complications in malignant hypertension. Successful management of malignant hypertension requires coordinated multidisciplinary care, continuous monitoring, and adherence to evidence-based blood pressure reduction strategies.