End organ damage usually refers to damage occurring in major
organs fed by the
circulatory system (
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 ...
,
kidneys,
brain,
eyes) which can sustain damage due to uncontrolled
hypertension,
hypotension, 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
A chest radiograph, called a chest X-ray (CXR), or chest film, is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures. Chest radiographs are the most common film taken in me ...
) 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 n ...
) or by
echocardiography
An echocardiography, echocardiogram, cardiac echo or simply an echo, is an ultrasound of the heart.
It is a type of medical imaging of the heart, using standard ultrasound or Doppler ultrasound.
Echocardiography has become routinely used in th ...
of less efficient function (
left ventricular failure).
* 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), 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 blur ...
,
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
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