Announcements
Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with MedReviews, LLC.
Open Access
Case Review
Malignant Hypertension Presenting as Hemolysis, Thrombocytopenia, and Renal Failure
Show Less
1
Department of Medicine, Cardiology Section, University of Missouri at Kansas City School of Medicine, Truman Medical Center, Kansas City, MO
2020
Divisions of Cardiology, Nutrition, and Preventive Medicine, William Beaumont Hospital, Royal Oak, MI
Rev. Cardiovasc. Med. 2003, 4(4), 255–259;
Published: 30 December 2003
Abstract
This case review describes a patient presenting to the emergency department with malignant hypertension, a medical emergency occurring in up to 1% of the hypertensive population. The features of malignant hypertension resemble those of other diseases. For example, the association between red-cell fragmentation and malignant hypertension is thought to be due to endothelial injury and fibrinoid necrosis, which promote hemolysis, platelet destruction, and varying degrees of renal failure, resulting in a clinical picture similar to that of thrombotic thrombocytopenic purpura. Resolving the hemolysis and improving the renal function can only be achieved through rapid and effective control of the blood pressure. Without treatment, the survival rate for malignant hypertension is 10% to 35%. With appropriate treatment, the 5-year survival rate is 75%.
Keywords
Hypertension
Thrombocytopenia
Hemolysis
Renal failure