Old 06-27-2012, 15:35   #1
ironstoNe
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A little case study

Now I am only an 18D student still, but I just wanted to share this with the current 18D's and those who have experience with the medical field. A friend of mine was telling me she has just noticed within the past 2 months that her blood pressure spikes to 180+ / 90+ at random times of the day. She is 38, maybe 100lbs, and in great shape (she runs between 6 - 12 miles quite often) There is no consistency to the rise in BP and she says that her labs, MRI, CT Scan, Renal Ultrasound, and Cardiogram are all normal. The docs said her renal artery seems intact as well. She does feel winded when this seems to happen and she feels quite a bit of pressure behind her eye and it's consistent. She is going back to the doctor Thursday for a possible angiogram, but that is about it. The docs can't find anything wrong with her other than low potassium levels, and are probably going to refer her to an endocrinologist. So I was just wondering if anyone on here may have the slightest clue as to what it could be from. I'm still thinking it out myself, but it seems to be a pretty interesting case. I would appreciate your feedback.

Thanks alot,

Nick (18D student)
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Old 06-27-2012, 15:54   #2
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Nick,

Was wondering if your friend has any history of HTN in her family, especially on her mother's side? I ask because my HTN was diagnosed when I turned 43, and I apparently get it from my mother. Both my mother and her mother (my grandmother) were diagnosed with HTN when they were 40.

You stated that your friend was 38, so this could be a precursor to hypertension, if it indeed runs in her family.
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Old 06-27-2012, 16:48   #3
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Could be early hypertension, but those numbers are quite high and are concerning.

Why is she having her blood pressure taken several times throughout the day, and how are the blood pressures being measured?

The eval so far sounds appropriate. She should be evaluated for hyperthyroid as well, and possibly consider screening for pheochromocytoma (an adrenaline-secreting tumor usually found in the abdomen).

It sounds like her doc is on the ball.

HTH.
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Old 06-27-2012, 16:48   #4
Eagle5US
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Quote:
Originally Posted by ironstoNe View Post
So I was just wondering if anyone on here may have the slightest clue as to what it could be from. I'm still thinking it out myself, but it seems to be a pretty interesting case. I would appreciate your feedback.

Thanks alot,

Nick (18D student)
Nick, while your curiosity is appreciated - situations like this without a current diagnosis are best NOT armchair quarterbacked. She has been / is being seen for her million dollar workup and (thus far) the experts with access to all of her lab and imaging do not yet have cause for her transient HTN.

Having uninformed - partially informed folks (that would be us) second guess / brainstorm her diagnostic process can be quite frustrating for her and her health care team.

Best to continue your conversations with her, learn from the MDMP (Medical Decision Making Process), and observe the process in action so you can utilize elements of it later on when necessary.

Once she knows what is going on, ask if she wouldn't mind if you shared it here.

Good luck in your studies.
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Old 07-01-2012, 19:32   #5
ironstoNe
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Originally Posted by Eagle5US View Post
Nick, while your curiosity is appreciated - situations like this without a current diagnosis are best NOT armchair quarterbacked. She has been / is being seen for her million dollar workup and (thus far) the experts with access to all of her lab and imaging do not yet have cause for her transient HTN.

Having uninformed - partially informed folks (that would be us) second guess / brainstorm her diagnostic process can be quite frustrating for her and her health care team.

Best to continue your conversations with her, learn from the MDMP (Medical Decision Making Process), and observe the process in action so you can utilize elements of it later on when necessary.

Once she knows what is going on, ask if she wouldn't mind if you shared it here.

Good luck in your studies.

Thanks sir,

I did get the OK from her to actually post about this to see if anyone had a clue, but I do understand the gravity of the situation and how this medical process works. She is being taken care of by her docs, I just thought it might be interesting to some of the readers on here to check out the case. I'll definitely let y'all know if anything does come up.

Nick
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Old 07-08-2012, 20:38   #6
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Originally Posted by Eagle5US View Post
Nick, while your curiosity is appreciated - situations like this without a current diagnosis are best NOT armchair quarterbacked. She has been / is being seen for her million dollar workup and (thus far) the experts with access to all of her lab and imaging do not yet have cause for her transient HTN.

Having uninformed - partially informed folks (that would be us) second guess / brainstorm her diagnostic process can be quite frustrating for her and her health care team.

Best to continue your conversations with her, learn from the MDMP (Medical Decision Making Process), and observe the process in action so you can utilize elements of it later on when necessary.

Once she knows what is going on, ask if she wouldn't mind if you shared it here.

Good luck in your studies.
Damn, Eagle...right on target again.
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Old 07-14-2012, 14:33   #7
ironstoNe
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Just an update on my friends status.. unfortunately a couple days ago she suffered a TIA, so she is in the hospital right now being treated and they are looking at a possible stent or balloon placement to be done..
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