HYPERTENSION

Hypertension



Hypertension

Case Analysis

Mary, a 50-year-old female executive had uncontrolled hypertension, despite medications. she was obese and fatigued and was therefore unable to exercise; she also had an uncontrollable appetite. The patient attended an in-residence chronic disorder program. Her weight dropped, and she was able to begin exercise; she also stopped both alcohol and tobacco. Six months following this program, she continued to have normal blood pressure on herbal preparations but no medications and was able to eat as much salt as she liked.

Medical History

Has history of high blood pressure and high cholesterol. Sedentary lifestyle. Heavy smoker. Absence of all other major illnesses noted.

Family History

No siblings. Father is a heavy smoker and has had two strokes in the past three years. Mother suffers from obesity. Grandparents died of old age and not of a major illness. No other major illness noted.

Social History

No heavy drinking. Smokes 2-3 packs of light cigarettes daily. Sedentary lifestyle. Lives alone. Works full time as sales executive.

Physical assessment

High blood pressure of 130/95. High cholesterol. Overweight (height is 180cm at 120kgs. Pulse is 95bpm. Temperature is 36.6C. Respiratory rate is 18. Patient is somewhat confused and suffers from blurred vision, slurred speech and loss of balance.

Tests

CT scan (Computed tomography (CT) scans are completed with the use of a 360-degree x-ray beam and computer production of images. These scans allow for cross-sectional views of body organs and tissues. CT scans are used to image a wide variety of body structures and internal organs. Since the 1990s, CT equipment has become more affordable and available. In some diagnoses, CT scans have become the first imaging exam of choice. Because the computerized image is so sharp, focused, and three-dimensional, many tissues can be better differentiated than on standard x rays. Common CT indications include:

Sinus studies. The CT scan can show details of a sinusitis, and bone fractures. Physicians may order CT of the sinuses to provide an accurate map for surgery.

Brain studies. Brain scans can detect haematomas, tumors, and strokes. The introduction of CT scanning, especially spiral CT, has helped reduce the need for more invasive procedures such as cerebral angiography.

Body scans. CT scans of the body will often be used to observe abdominal organs, such as the liver, kidneys, adrenal glands, spleen, and lymph nodes, and extremities.

MRI (Magnetic Resonance Imaging is an examination, which allows the doctor to see detailed images of soft tissues, bone, fat, muscles and internal organs in your body without the use of x-rays. It is a diagnostic examination which provides information not possible with any other means. Frequently this advantage can permit early diagnosis and perhaps eliminate the need for surgical procedures.

Brain and Spine

MRI gives very clear pictures of the brain and spine. MR has effectively replaced CT for the diagnosis of most diseases of the brain and spine. Some outstanding exceptions include patients with spine fractures and acute head trauma.

Musculoskeletal System

MRI is very sensitive to changes in cartilage and bone structure resulting from injury, disease or aging, and can often provides information not available ...