Case of the Month #20 - hypertension

Published 01/02/2022

What investigations would be useful to order in this case?

Investigations to screen for end-organ damage:

  • ECG, troponins, Echocardiogram
  • Fundoscopy
  • Urea, Creatinine, eGFR, Urine albumin:creatinine ratio
  • Full blood count, coagulation screen, fibrinogen, D-Dimer
  • CT/MRI Head if concerns re: encephalopathy

Investigations to screen for the most common secondary causes of hypertension in this age group:

  • Renal ultrasound including Doppler examination of renal arteries.
  • Pregnancy test
  • 24 hour urinary cortisol (Cushing’s syndrome)
  • Plasma or 24 hour urinary metanephrines (Phaeochromocytoma)
  • Plasma renin and aldosterone (Conn’s syndrome)
  • Thyroid function tests