Pathology -Malignant hypertension
Findings from an expedited program for treating essential or secondary hypertension Prevalent among adolescent African American males. Pathology: Arteriole: Hyperplastic arteriosclerosis is characterized by the concentric, laminated onion skin thickening of arterial walls, accompanied by necrotizing arteriolitis, which involves the deposition of fibrinoid in arteriole walls and subsequent necrosis and inflammation. This condition can lead to other pathological conditions, such as left ventricular hypertrophy and failure, as well as malignant nephrosclerosis, which involves the rupture of glomerular capillaries and the resulting appearance of a flea-bitten kidney. Medical Presentation Frequently manifests as a hypertensive crises, characterized by symptoms such as headache, altered mental status, blurred vision, chest pain, or dyspnea. The physical examination reveals a misplaced and powerful point of maximal impulse at the cardiac apex. Additionally, there is the presence of S4, papilledema, ocular hemorrhages and exudates, and a significant increase in diastolic pressure above 120 mm Hg. Therapy The blood pressure is initially reduced using intravenous medications such as nitroprusside, hydralazine, or labetalol, and then maintained at a controlled level with oral medications. Frequently leads to premature mortality Hyaline arteriosclerosis is linked to essential hypertension or diabetes and is characterized by the thickening of tiny arteries and arterioles, particularly in the kidney (known as benign nephrosclerosis).
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