Malignant hypertension physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Physical examination
Vital Signs
- Blood pressure must be checked in both arms to screen for aortic dissection or coarctation.
- Orthostatic vital signs
Eyes
- A funduscopic examination may reveal silver wiring (Grade I retinopathy), AV nipping (Grade II) flame-shaped retinal hemorrhages, soft exudates (Grade III), or papilledema (Grade IV)
Head and Neck
- Examination of jugular veins
- Carotid bruits
Heart
- Third or fourth heart sound or murmurs.
Lungs
Abdomen
- Renal bruits
- Assessment of liver size
Extremities
Neurologic
- Focal neurologic signs
- Focal signs of subarachnoid hemorrhage, infarct, or the presence of a mass.