A hypertensive emergency is a particularly severe, sudden form of high blood pressure that can damage one or more vital organs.
Hypertensive emergencies occur when blood pressure rapidly increases.
In children, the first symptoms of a hypertensive emergency are typically a headache, listlessness, confusion, and seizures and, in infants, irritability.
Doctors diagnose hypertensive emergency by measuring blood pressure and doing tests for organ damage, such as electrocardiography, echocardiography, and blood and urine tests.
Treatment of hypertensive emergencies involves admitting children to an intensive care unit and giving drugs by vein to lower blood pressure as soon as possible.
When blood pressure is checked, two values are recorded. The higher value reflects the highest pressure in the arteries, which is reached when the heart contracts (during systole). The lower value reflects the lowest pressure in the arteries, which is reached just before the heart begins to contract again (during diastole). Blood pressure is written as systolic pressure/diastolic pressure—for example, 120/80 mm Hg (millimeters of mercury), referred to as 120 over 80.
A hypertensive emergency is a particularly severe, sudden form of high blood pressure. Diastolic blood pressure (the bottom number) is usually over 100 mm Hg, and there is evidence of progressive damage in one or more vital organs (typically the brain, heart, eyes, and kidneys). Children may have a variety of symptoms.
Hypertensive emergencies are relatively rare in children. They may develop in children who have or have not been previously diagnosed with high blood pressure.
Hypertensive emergencies usually occur when blood pressure rapidly increases. What causes the rapid increase varies by age. The most common causes are
During infancy: Birth defects of the kidneys, bronchopulmonary dysplasia, coarctation of the aorta, renal vein thrombosis, and other disorders that affect the blood vessels to the kidneys
During childhood: Kidney tissue disease, disorders that affect the blood vessels to the kidneys, hormonal disorders, drugs, and toxins
During adolescence: Kidney tissue disease, not taking drugs they were prescribed for their high blood pressure, and use of drugs such as stimulants (for example, amphetamines and cocaine), anabolic steroids, corticosteroids, or certain oral contraceptives (birth control pills)
A hypertensive emergency, if not treated promptly, typically causes progressive damage in one or more vital organs, particularly the following:
Brain, which can result in deterioration of brain function, seizures, and/or coma
Heart, which can result in heart failure
Eyes, which can result in papilledema (swelling of the optic nerve) and bleeding in the retina
Kidneys, which can result in kidney dysfunction or failure
If untreated, a hypertensive emergency can be fatal.
A hypertensive urgency is severe high blood pressure that has not yet caused enough organ damage to result in symptoms.
