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Hypertension/High Blood Pressure Health Center

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Malignant Hypertension

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How Is Malignant Hypertension Diagnosed?

A diagnosis of malignant hypertension is based on blood pressure readings and signs of acute organ damage.

If you have symptoms of malignant hypertension, the doctor will:

  • Recheck your blood pressure and listen to your heart and lungs for abnormal sounds
  • Examine your eyes to check for damage to the blood vessels of the retina and swelling of the optic nerve
  • Order blood and urine tests that may include:

Additional blood tests may be needed, depending on the result of the tests listed above.

The doctor will also ask for imaging tests, including:

  • Echocardiogram to check heart function and blood flow through the heart
  • Electrocardiogram (ECG) to check the heart’s electrical function
  • Chest X-ray to look at the shape and size of the heart structures and to detect fluid in the lungs
  • Other imaging tests to evaluate the kidneys and their arteries


How Is Malignant Hypertension Treated?

Malignant hypertension is a medical emergency and needs to be treated in a hospital, often in an intensive care unit. The doctor will consider your symptoms and overall health when deciding what treatment plan is best for you. The goal of treatment is to carefully lower your blood pressure within a matter of minutes.

You will receive blood pressure medicines through an IV, which is the quickest way to treat extremely high blood pressure. Once blood pressure is at a safe level, the medications may be switched to oral forms. If you develop kidney failure, you may need kidney dialysis.

Other treatments depend on your specific symptoms and possible causes of the malignant hypertension.

What Are Complications of Malignant Hypertension?

Untreated, malignant hypertension causes death. Complications of malignant hypertension also may include:

  • Aortic dissection, which is a sudden rupture of the main blood vessel leaving the heart
  • Coma
  • Fluid in the lungs, called pulmonary edema
  • Heart attack
  • Heart failure
  • Stroke
  • Sudden kidney failure

Immediate medical treatment decreases your chances for life-threatening complications.


WebMD Medical Reference

Reviewed by James Beckerman, MD, FACC on November 21, 2015
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