pediatrics
Hypertension in Children
Symptoms and Signs of Hypertension in Children
Hypertension in children, with the rare exception of Hypertensive Emergencies in Children , is usually asymptomatic. The physical examination may be normal (other than the elevated blood pressure), but signs of hypertension and/or its causes are sometimes present and should be specifically sought, including Eyes: Proptosis ( Hyperthyroidism in Infants and Children ), hypertensive retinopathy (arteriolar spasm, hemorrhages, exudates, and rarely papilledema) Head and face: Moon facies ( Cushing Syndrome , such as Neck: Thyroid enlargement and/or tenderness ( Hyperthyroidism in Infants and Children ) Heart: Murmur ( Palpation ), friction rub (collagen vascular disease), apical heave ( Abdomen: Mass (tumor, Autosomal recessive polycystic kidney disease , hydronephrosis), bruit (renovascular disease) Extremities: Edema (kidney disease), joint swelling (collagen vascular disease), lower extremity traction or cast (orthopedic-related hypertension) Genitalia: Ambiguous/virilization ( Overview of Congenital Adrenal Hyperplasia ), advanced puberty (intracranial tumor) Skin: Pallor/flushing ( Pheochromocytoma ), acne/hirsutism/striae ( Neurologic: Muscle weakness ( Primary Aldosteronism , General: Obesity (primary/essential hypertension), growth retardation ( Chronic Kidney Disease ) Vital signs: Tachycardia ( Hyperthyroidism in Infants and Children , 1.O'Neill JA, Berkowitz H, Fellows KJ, Harmon CM: Midaortic syndrome and hypertension in childhood.J Pediatr Surg30(2):164–171; discussion 171-2, 1995. doi: 10.1016/0022-3468(95)90555-3 