Background: Transient elevations of blood pressure are common in hospitalized older adults and may lead inpatient clinicians to intensify inpatient antihypertensive therapy and discharge patients on these intensified regimens. Intensification of outpatient regimens during hospitalization can easily become over-treatment once patients return home, increasing patients’ risk of adverse drug events including syncope and falls. Thus, [...]

Background: There is no consensus on the management of asymptomatic inpatient hypertension. This is alarming as the prevalence of inpatient hypertension may be as high as 72%. Hypertension treatment guidelines focus on chronic hypertension in the outpatient setting and evidence for inpatient management is lacking. Aggressive treatment of asymptomatic inpatient hypertension with intravenous antihypertensives is [...]

Background: Elevated blood pressure (BP) is common among hospitalized patients, with prevalence estimates between 50-70%. Many factors may contribute to this, such as pain, nausea, anxiety, or volume overload. However, true hypertensive emergency requiring rapid reduction in BP is relatively rare. The easy availability of intravenous (IV) antihypertensives may lead to unnecessary treatment of asymptomatic [...]

Background: Hypertensive crisis is classified as either hypertensive emergency or hypertensive urgency, distinguished by presence or absence of end-organ damage, respectively. Guidelines recommend treating hypertensive emergency with intravenous (IV) antihypertensive medications for immediate blood pressure reduction. On the other hand, management of hypertensive urgency involves gradual reduction of blood pressure over hours to days using [...]

Case Presentation: A 46 year-old man with a past medical history of untreated hypertension presented with right ptosis and miosis. The patient was in his usual state of health until one month prior to presentation, when he developed right retrobulbar pain in the absence of additional upper airway or constitutional symptoms. The patient subsequently noticed [...]

Case Presentation: A 15 year-old female with developmental delay presents with intermittent abdominal pain, decreased appetite, and vaginal discharge. Parents disclose a 30 lbs weight loss over 2 years, along with vaginal discharge that was evaluated by self-swab testing and deemed a “normal variant” from menses. When she presented to her PCP’s office, she was [...]

Case Presentation: An 18 year old Spanish speaking male from Honduras presented following a motor vehicle accident. Initial assessment in the ED included a CXR and bedside Echocardiogram which noted cardiomegaly and a reduced EF of 15%. Patient reports experiencing headaches, blurry vision, palpitations, and non-radiating left sided chest pressure intermittently over the last four [...]

Case Presentation: A 64-year-old year old woman with no personal or family history of HTN was diagnosed with right renal angiomyolipoma incidentally on work up for latent TB and referred to interventional radiology for partial right RAE. On routine follow up one week post procedure, she was noted to be normotensive. One-month post procedure while [...]

Case Presentation: A 46 year-old man with bipolar disorder and hypertension presented to the emergency department (ED) with total body pain. He had been at the local airport when he had sudden onset total body throbbing sharp pain. He collapsed on the floor and a bystander called EMS who transported him to our ED. His [...]

Case Presentation: A 72 year old male presented with worsening shortness of breath and increasing oxygen requirement for six weeks. The patient had been on supplemental oxygen for the past 2 years for hypoxia. As an outpatient, right heart catheterization revealed a pulmonary arterial pressure (PAP) of 76/24 mmHg, mean PAP of 41 mmHg, wedge [...]