children s health issues
High Blood Pressure Emergencies in Children
Introduction
A hypertensive emergency is a particularly severe, sudden form of high blood pressure that can damage one or more vital organs. (See also High Blood Pressure in Children and 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: Kidney Defects , During childhood: Kidney tissue disease, Overview of Blood Vessel Disorders of the Kidneys , hormonal disorders, drugs, and toxins ), Anabolic Steroids , corticosteroids, or certain oral contraceptives (birth control pills) Ahypertensive 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 (HF) None Eyes, which can result in papilledema (swelling of the optic nerve) and bleeding in the retina Kidneys, which can result in Overview of Kidney Failure None If untreated, a hypertensive emergency can be fatal. Ahypertensive urgencyis severe high blood pressure that has not yet caused enough organ damage to result in symptoms. 