pediatrics
Hypertensive Emergencies in Children
Symptoms and Signs
BP is markedly elevated, typically to stage 2 hypertension levels or higher (see table Classification of Blood Pressure (BP) in Children ). In children, hypertensive emergencies manifest primarily as hypertensive encephalopathy, typically with headache, altered mental status (eg, lethargy, confusion, coma), seizures, and, in infants, irritability. These manifestations should resolve with lowering of BP. Heart failure in hypertensive children may cause tachypnea, pulmonary edema, gallop rhythm, or a new or changed heart murmur. Renal insufficiency is usually asymptomatic, but peripheral edema may be present. Hypertensive retinopathy may be present, with papilledema, hemorrhages, and/or exudates. 