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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Accelerated Hypertension And High BP

Last June, my now 71-year-old mom became disillusioned and didn t know where she was. She was talking out of her head , too, not making any sense. A Cat scan showed nothing. Now, she is continually dizzy and has pressure in her head all the time. Her doctor contributed it to high blood pressure. He claims it to be Accelerated hypertension, and has been treating it as such. No meds are helping. She is still dizzy all the time and the pressure is still there. All the doctor does is keep switching meds to see what works . I m fearful of a tumor. She s been in and out of the ER so many times, and no one or nothing is helping. I would appreciate your advice.
Tue, 10 May 2016
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General & Family Physician,  's  Response
Hello,thanks for using Healthcaremagic. i had gone through all the data that you have posted. feel sorry for that you are going through all this. i try to put it in a simple way.
Feeling of dizziness can be attributed to accelerated hypertension but this improves with BP control. differential diagnosis include
1) cerebro vascular accident: clinical examination is the key here to rule out other causes that call dizziness continously like lateral medullary infarction, a small cerebellar infarct which could have been easily misssed on a CAT scan and can be seen on MRI brain.
presence of other features like ataxia, not able to balance on standing, feeling of sensation difference between two halfs of body and face on examination points to disturbance in brain like infarction.
2) dyselectrolytemia: like hyponatremia most commonly cause by dieretics which they are on for treatment of hypertension may cause this kind of symptoms.
after ruling other possible cause then we dont find any then we should attribute it to accelerated htn.
we need to increase the dose of anti hypertensive medications and try different combinations to decrease and control the blood pressure.
dietary modifications are also improtant to avoid pickles, salted foods and decrease salt content in diet.
so coming to your senario
review the medications she is on for hypertension, if there are dieuretics in it get serum electrolytes done like serum sodium level.
get review clinical examination to look for any signs and if any u need to get MRI brain. hope you find this useful..
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Suggest Treatment For Accelerated Hypertension And High BP

Hello,thanks for using Healthcaremagic. i had gone through all the data that you have posted. feel sorry for that you are going through all this. i try to put it in a simple way. Feeling of dizziness can be attributed to accelerated hypertension but this improves with BP control. differential diagnosis include 1) cerebro vascular accident: clinical examination is the key here to rule out other causes that call dizziness continously like lateral medullary infarction, a small cerebellar infarct which could have been easily misssed on a CAT scan and can be seen on MRI brain. presence of other features like ataxia, not able to balance on standing, feeling of sensation difference between two halfs of body and face on examination points to disturbance in brain like infarction. 2) dyselectrolytemia: like hyponatremia most commonly cause by dieretics which they are on for treatment of hypertension may cause this kind of symptoms. after ruling other possible cause then we dont find any then we should attribute it to accelerated htn. we need to increase the dose of anti hypertensive medications and try different combinations to decrease and control the blood pressure. dietary modifications are also improtant to avoid pickles, salted foods and decrease salt content in diet. so coming to your senario review the medications she is on for hypertension, if there are dieuretics in it get serum electrolytes done like serum sodium level. get review clinical examination to look for any signs and if any u need to get MRI brain. hope you find this useful..