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Hypertensive encephalopathy (HE) is general brain dysfunction due to significantly high blood pressure. [3] Symptoms may include headache, vomiting, trouble with balance, and confusion. [1] Onset is generally sudden. [1] Complications can include seizures, posterior reversible encephalopathy syndrome, and bleeding in the back of the eye. [1] [3]
Similar to hypertensive retinopathy, evidence of nerve fiber infarcts due to ischemia (cotton-wool spots) can be seen on physical exam. Symptoms may include headache, nausea, or vomiting. Chest pain may occur due to increased workload on the heart resulting in inadequate delivery of oxygen to meet the heart muscle's metabolic needs.
The CRP and ESR are sometimes elevated in myocarditis but they are not specific as they may be elevated due to many other causes. [31] Similarly, CK may be elevated in myocarditis but is also non-specific, as it may be elevated in myositis (skeletal muscle injury). [31] High sensitivity troponin is usually elevated in myocarditis and this ...
[27] [28] [29] High troponin T levels have also been reported in patients with inflammatory muscle diseases such as polymyositis or dermatomyositis. [30] [31] Troponins are also increased in rhabdomyolysis. In hypertensive disorders of pregnancy such as preeclampsia, elevated troponin levels indicate some degree of myofibrillary damage. [32] [33]
A complete blood count may show an elevated white count and a serum C-reactive protein may be elevated. Acute pericarditis is associated with a modest increase in serum creatine kinase MB (CK-MB). [ 5 ] and cardiac troponin I (cTnI), [ 6 ] [ 7 ] both of which are also markers for injury to the muscular layer of the heart.
The level of the troponin, as well as a change over time, are useful in measuring and diagnosing or excluding myocardial infarctions, and the diagnostic accuracy of troponin testing is improving over time. [72] One high-sensitivity cardiac troponin can rule out a heart attack as long as the ECG is normal. [83] [84]
It can be difficult to distinguish unstable angina from non-ST elevation (non-Q wave) myocardial infarction. [4] [5] They differ primarily in whether the ischemia is severe enough to cause sufficient damage to the heart's muscular cells to release detectable quantities of a marker of injury, typically troponin T or troponin I.
Other symptoms include cardiac arrhythmias (especially in those taking digoxin), fatigue, nausea, vomiting (emesis), loss of appetite, abdominal pain, & paralytic ileus. If kidney impairment occurs as a result, manifestations can include increased urination , urination at night , and increased thirst . [ 6 ]