End organ damage usually refers to damage occurring in major
organs fed by the
circulatory system
The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...
(
heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to t ...
,
kidney
The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blo ...
s,
brain
A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a ve ...
,
eyes
Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well as enabling several photo response functions that are independent of vision. Eyes detect light and con ...
) which can sustain damage due to uncontrolled
hypertension,
hypotension
Hypotension is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure is indicated by two numbers, the systolic blood pressure (the top number) and the dia ...
, or
hypovolemia.
Evidence of hypertensive damage
In the context of hypertension, features include:
* Heart - evidence on
electrocardiogram screening
of the heart muscle thickening (but may also be seen on
chest X-ray) suggesting
left ventricular hypertrophy
Left ventricular hypertrophy (LVH) is thickening of the heart muscle of the left ventricle of the heart, that is, left-sided ventricular hypertrophy and resulting increased left ventricular mass.
Causes
While ventricular hypertrophy occurs ...
) or by
echocardiography of less efficient function (
left ventricular failure
Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, an ...
).
* Brain- hypertensive encephalopathy, hemorrhagic stroke, subarachnoid hemorrhage, confusion, loss of consciousness, eclampsia, seizures, or transient ischemic attack.
* Kidney - leakage of protein into the urine (
albuminuria
Albuminuria is a pathological condition wherein the protein albumin is abnormally present in the urine. It is a type of proteinuria. Albumin is a major plasma protein (normally circulating in the blood); in healthy people, only trace amounts of ...
or
proteinuria
Proteinuria is the presence of excess proteins in the urine. In healthy persons, urine contains very little protein; an excess is suggestive of illness. Excess protein in the urine often causes the urine to become foamy (although this symptom ma ...
), or reduced
renal function,
hypertensive nephropathy, acute renal failure, or glomerulonephritis.
* Eye - evidence upon
fundoscopic examination of
hypertensive retinopathy
Hypertensive retinopathy is damage to the retina and retinal circulation due to high blood pressure (i.e. hypertension).
Signs and symptoms
Most patients with hypertensive retinopathy have no symptoms. However, some may report decreased or blurr ...
,
retinal hemorrhage, papilledema and blindness.
* Peripheral arteries - peripheral vascular disease and chronic lower limb ischemia.
Evidence of shock
In the context of poor end organ perfusion, features include:
* Kidney - poor urine output (less than 0.5 mL/kg), low glomerular filtration rate.
* Skin - pallor or mottled appearance, capillary refill > 2 secs, cool limbs.
* Brain - obtundation or disorientation to time, person, and place. The
Glasgow Coma Scale
The Glasgow Coma Scale (GCS) is a clinical scale used to reliably measure a person's level of consciousness after a brain injury.
The GCS assesses a person based on their ability to perform eye movements, speak, and move their body. These thre ...
may be used to quantify altered consciousness.
* Gut - absent bowel sounds, ileus
References
Medical terminology
{{med-diagnostic-stub