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Hypertension Evaluation Exam

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Hypertension Evaluation Exam

  • Goals
  1. Identify end organ damage
  2. Identify signs Secondary Hypertension
  3. Identify reversible exacerbating factors
  4. Document progression
  • Exam
  • Vitals
  1. BP Examination
    1. Consider arm to leg systolic BP measurements (difference >20 mmHg suggests Aortic Coarctation)
  2. Pulse
  3. Assess for Obesity
    1. Weight and Height
    2. Ideal Body Weight or BMI
    3. Waist Circumference (assess for Metabolic Syndrome)
  • Exam
  • Neck
  1. Thyroid exam
  2. Carotid Bruits
  3. Neck vein exam
  1. Congestive Heart Failure signs
  2. Palpable intercostal pulses
  • Exam
  • Cardiovascular
  1. S4 Gallop rhythm (decreased LV compliance)
  2. Tachycardia
  3. Accentuated S2 Heart Sound
  4. Aortic Insufficiency murmur
  5. Abnormal EKG or Echocardiogram
  6. Prior Angiography results
  1. Renal artery bruit
    1. May be present in Renal Artery Stenosis
  2. Abdominal Aortic Aneurysm
  3. Enlarged or tender Kidneys (CVA pain)
  • Exam
  • Genitourinary
  1. Abnormal Sexual Development
  2. Enlarged Prostate
  1. Femoral bruits
  2. Femoral pulses
    1. Delayed or absent in Aortic Coarctation
  3. Symmetrical pulses
  4. Lower extremity shin Hair Loss
  • Exam
  • Neurologic
  • Exam
  • Skin
  1. Stigmata of Cirrhosis
  2. Neurofibromata
  3. Chloasma
  4. Signs of Cushing's Disease
    1. Striae
    2. Acne Vulgaris
    3. Hirsutism