Friday, July 2, 2010

Hypertension in Young Adult

60 years old Malay female who was diagnosed to have hypertension and diabetis mellitus for 30 years presented to casualty with shortness of breath.

Look at her age and time of diagnosis for DM and HPT. You should realize that this is a known case of young hypertension. She was diagnosed to have hypertension at age of 30.
Remember to ask about :

1) How she was diagnosed at that time?
2) What was her symptoms at that time?
3) Exclude secondary causes - what investigation?
4) Where she was diagnosed? Some small clinic may not investigate for secondary hypertension which means that they did not treat the underlying cause of hypertension. Private hospital or teaching hospital usually would not miss this secondary causes
5) Complication of hypertension
...and so on...

CPG Management of Hypertension, 3rd Edition, Ministry of Health, Malaysia

Of course dont forget about diabetes as well. She was diagnosed to have DM at age of 30 (<40 years old). So what should you ask? Anyway, my post here just want to make sure that you guys would not be tricked with this type of scenario and you should not miss to ask about secondary hypertension. Thanks to Prof Shahrir for this information. This info may not be sufficient to you guys. So please read on secondary hypertension. Oh ya, i'm not going to touch on SOB parts. Please include the complications of HPT and DM to your differential diagnosis to SOB as well (e.g. renal failure). =)


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