Hypertensive emergency presenting as blurry vision in a patient with hypertensive chorioretinopathy

• Published in: International journal of emergency medicine Vol. 8; no. 1
• Main Authors: Stacey, Andrew W, Sozener, Cemal B, Besirli, Cagri G
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 2015; Springer Nature B.V
• Subjects: Angiology; Cardiology; Case Report; Emergency Medicine; Internal Medicine; Medicine; Medicine & Public Health; Pediatrics; Hypertensive emergency; Fundus photography; Hypertensive retinopathy; Hypertensive choroidopathy
• ISSN: 1865-1372; 1865-1380
• DOI: 10.1186/s12245-015-0063-6

A 42-year-old man presented with 3 weeks of blurry vision in the right eye. His exam was significant for decreased vision in the right eye, diffuse retinopathy in both eyes, and serous retinal detachment in the right eye. The patient was found to be hypertensive with blood pressure of 256/160 mmHg. He was diagnosed with hypertensive emergency with end-organ damage due to features of hypertensive chorioretinopathy. He was admitted with abnormal urinalysis, elevated troponin, and abnormal EKG. After appropriate control of his blood pressure, his vision and his labs normalized. Hypertensive emergencies can be manifested first in the eyes. When the choroid is associated, the hypertensive event is often more acute and associated with increased morbidity. It is imperative to obtain a fundus exam in any patient with elevated blood pressure and concomitant vision complaints.