Non-invasive ventilation and intravenous antihypertensive therapy stabilized malignant hypertension manifesting with painless hematuria and acute pulmonary edema in a 35-year-old man.
Case Report (n=1)
No
Painless hematuria in a young adult can be an early manifestation of hypertensive renal microangiopathy in malignant hypertension, which may rapidly progress to acute pulmonary edema and acute kidney injury.
Malignant hypertension is an acute, life-threatening form of severe hypertension characterized by rapidly progressive target-organ damage involving the kidneys, retina, central nervous system, and cardiovascular system. Early recognition is critical to prevent irreversible injury. We report the case of a previously healthy 35-year-old man presenting with one week of painless macroscopic hematuria followed by sudden-onset dyspnea with pink frothy sputum. Evaluation revealed severely elevated blood pressure, grade 4 hypertensive retinopathy, acute pulmonary edema, proteinuric hematuria, hypokalemia, and acute kidney injury. The patient required non-invasive ventilation, intravenous antihypertensive therapy, and multiple sessions of hemodialysis. This case highlights the importance of recognizing hematuria as an early manifestation of hypertensive renal microangiopathy and emphasizes the multi-system involvement that characterizes malignant hypertension.
Meenakumari1, Rathnakumar G.2, Dr. Arun Muraleedharan3* (Sun,) conducted a case report in Previously healthy 35-year-old male with malignant hypertension presenting with painless gross hematuria and acute pulmonary edema (n=1). Non-invasive ventilation, intravenous antihypertensive therapy, intravenous diuretics, and multiple sessions of hemodialysis was evaluated on Stabilization of patient condition with resolution of acute complications of malignant hypertension. Non-invasive ventilation and intravenous antihypertensive therapy stabilized malignant hypertension manifesting with painless hematuria and acute pulmonary edema in a 35-year-old man.