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Secondary Hypertension in Preventive Cardiology: A Rare Rheumatologic Disease

A previously healthy 16-year-old black female presented with hypertension, 20 pound weight loss, fatigue, exercise intolerance and epistaxis. She described a throbbing headache for ten days. Systolic BP (SBP) was 110mmHg five months prior. Exam revealed cachexia, tachycardia, normal rhythm, 2/6 blowing systolic murmur LLSB, and an S3 gallop. Pulses: right brachial faint, left brachial 1+ and bilateral femoral 3+. SBP was 130mmHg in the left upper extremity, unable to be auscultated on the right, and 260mmHg in right lower extremity. EKG: sinus tachycardia, 109bpm, nonspecific ST-T wave changes in lateral …