Misdiagnosis of Hypertension
Alternative diagnoses list for Hypertension:
For a diagnosis of Hypertension,
the following list of conditions
have been mentioned in sources
as possible alternative diagnoses
to consider during the diagnostic process for Hypertension:
Diseases for which Hypertension may be an alternative diagnosis
The other diseases for which Hypertension
is listed as a possible alternative
diagnosis in their lists include:
Hypertension: Hidden Causes Misdiagnosed?
Causes of Hypertension may include these medical conditions:
Rare Types of Hypertension:
Hypertension Diagnosis: Book Excerpts
Hypertension: Medical Mistakes
Related medical mistakes may include:
Hypertension: Undiagnosed Conditions
Commonly undiagnosed conditions in related areas may include:
Common Misdiagnoses and Hypertension
Metabolic syndrome often undiagnosed: Metabolic syndrome, also known as Syndrome X, is
an often overlooked medical condition that causes a cluster of chronic symptoms.
There are often four symptoms and conditions combined: obesity, hypertension (high blood pressure),
high cholesterol, and diabetes (Type 2 diabetes) or in come cases pre-diabetes initially.
See the introduction to metabolic syndrome.
Heart attacks can be undiagnosed: Although the most severe symptoms of heart attack are hard to miss,
there are varying degrees of severity.
It is altogether too common for people to die from undiagnosed heart attack, or from delaying too long
to call for emergency help.
The prognosis for treatment is far better for patients treated in the early stages of a heart attack.
The most common misdiagnoses include heartburn, or other less severe causes of chest pain.
See the introduction to heart attack and the symptoms of heart attack.
Heart attacks can be overdiagnosed: Although many people die from heart attacks, there are also
many cases where people fear that they have a heart attack, but actually have something milder.
Some of the conditions which may be causes of chest pain, causing fear of a heart attack, including
an anxiety attack, heartburn, and so on.
See the causes of chest pain and the symptoms of heart attack.
Unnecessary hysterectomies due to undiagnosed bleeding disorder in women: The bleeding disorder
called Von Willebrand's disease is quite common in women, but often fails to be correctly diagnosed.
Women with the condition tend to have heavy periods, since they actually have a bleeding disorder.
Severe afflictions may result in the women receiving a hysterectomy unnecessarily, when the
underlying cause has not been identified.
See the introduction to Von Willebrand's disease and bleeding disorder.
Rare heart condition often undiagnosed: The rare heart condition called long QT syndrome can lead to episodes of palpitations
and rapid heartbeat.
In rare cases, this undiagnosed condition can be fatal.
It should be considered for any unexplained heart rhythm abnormality.
Heart attack can be over-diagnosed: Although heart attack is often undiagnosed,
leading to fatality, it can also be over-diagnosed.
People become concerned that a condition is a heart attack,
whereas there are various less dangerous possibilities.
After all, there are numerous causes of chest pain.
Some of the common conditions where a person may become concerned
about a possible heart attack include a panic attack (which often has
both chest pain and difficulty breathing), and heartburn/reflux type conditions.
Nevertheless, chest pain itself can be a potentially life-threatening symptoms,
and needs immediate professional attention.
Blood pressure cuffs misdiagnose hypertension in children: One known misdiagnosis issue
with hyperension, arises in relation to the simple equipment used to test blood pressure.
The "cuff" around the arm to measure blood pressure can simply be too small to accurately
test a child's blood pressure.
This can lead to an incorrect diagnosis of a child with hypertension.
The problem even has a name unofficially: "small cuff syndrome".
See misdiagnosis of hypertension.
Over-diagnosis of pulmonary hypertension in obese patients: A diagnosis
of pulmonary hypertension, particularly pulmonary arterial hypertension,
is often a misdiagnosis in obese patients.
Exertional dyspnea leads to a diagnostic reading of high right ventricular systolic pressure,
which seems to indicate pulmonary hypertension, but is ultimately found to be an
incorrect diagnosis.
See misdiagnosis of pulmonary hypertension.
Obesity-related conditions undiagnosed in children: A variety of conditions
are associated with obesity (see obesity), but these tend to be undiagnosed more often
in child patients than in adults.
Some of the overlooked conditions may include hypertension, diabetes, acanthosis nigricans, etc.
See misdiagnosis of obesity or introduction to obesity.
Hypertension misdiagnosis common in children: Hypertension is often
misdiagnosed in adults (see misdiagnosis of hypertension), but its misdiagnosis is even more likely in children.
Some of the symptoms of hypertension that can be overlooked include chest pain, headaches, abdominal pain, etc.
See symptoms of hypertension or misdiagnosis of hypertension.
Silent attack in diabetics: Heart disease is the leading cause of death among diabetics. Patients with type 2 diabetes above the age of 60-65 years are susceptible to silent heart attacks.Diabetes being a multi systemic disorder also affects the nerves causing autonomic neuropathy hence making the heart attack painless.Diabetics who are smokers and have increased blood pressure are more prone for silent attacks and hence these group of patients must undergo screening tests like a treadmill stress test.Some of the symptoms that patients can experience includes mild discomfort in the chest,jaw or arms which is relieved on taking rest,shortness of breath and tiredness. Some of the investigations in addition to a good clinical history that need to be done include an electrocardiogram,estimation of the cardiac enzymes.
Lack of early signs in renal cell carcinoma: Renal cell carcinoma lacks early warning signs
and makes a much generalised presentation. Hence the chances of it being
misdiagnosed are higher. It has to be differentiated from conditions like renal
abscess, metastatic disease, infected or hemorrhagic cyst and lymphoma. The
prognosis of patients with RCC depends on its stage at diagnosis. The prognosis
is worst for patients with metastatic disease at presentation and best for
patients with small masses confined to the kidney.
Cushing's syndrome of obesity?: Cushing’s syndrome usually occurs
due to chronic steroid administration, bilateral adrenal hyperplasia, adrenal
tumour and ACTH excess. Morbidity and mortality
associated with Cushing syndrome are related primarily to the effects of excess
glucocorticoids. The patient usually presents to the doctor with features of
weight gain more so on the face with skin changes, depression and muscle
weakness. A proper history is needed to rule out conditions like obesity,
bulimia, alcoholism and depression.
Hypertension: Rare Types
Rare types of medical disorders and diseases in related medical areas:
Failure To Diagnose Hypertension
Failure to diagnose Hypertension may be associated with the following:
- Undiagnosed hypertension can increase the risk of heart attack, stroke, heart failure and arterial aneurysm
- Undiagnosed hypertension can lead to kidney damage or failure, brain damage, arteriosclerosis and aortic dissection
- Undiagnosed hypertension can lead to damage to the retina (hypertensive retinopathy) and vision loss
- Undiagnosed severe hypertension can result in death within a matter of years unless it is treated. Severe hypertension is considered as blood pressure that is at least 50% greater than the average
- Undiagnosed hypertension can result in complications such as malignant hypertension where the blood pressure inside the skull increases also
- Undiagnosed high blood pressure during pregnancy can lead to complications such as pre-eclampsia, HELLP syndrome and eclampsia
- Hypertension often causes no symptoms until it is severe and regular checkups can allow a timely diagnosis
Notes On Hidden Causes Of Hypertension
The following may be hidden causes of Hypertension:
- Causes of secondary hypertension: atheroma, fibromuscular dysplasia, renal emboli, renal artery thrombosis, Polycystic kidneys, scleroderma, analgesic nephropathy, gouty nephropathy, heavy metal poisoning, inborn errors of adrenal steroid metabolism (17 alpha-hydroxylase deficiency 11 beta-hydroxylase deficiency), Liddle's syndrome, myxoedema, increased intracranial pressure and iatrogenic
- Secondary hypertension can be caused by kidney disease, certain tumors, adrenal gland tumors, primary aldosteronism, Cushing's syndrome, coarctation of the aorta, cocaine use, kidney inflammation, narrowed kidney arteries, migraine medications, haemolytic-uremic syndrome, Henoch-Schonlein purpura, periarteritis nodosa, pregnancy, radiation enteritis, Wilms' tumor, retroperitoneal fibrosis and pheochromocytoma
- Primary hypertension has no specific cause but certain factors may contribute to an increased blood pressure: insulin resistance, genetic predisposition, age, renin homeostasis and salt sensitivity
- Pain can cause hypertension
- Sleep apnea can be a hidden cause of hypertension
- Increased age usually involves less elastic arteries which can contribute to high blood pressure
- Certain medications can increase blood pressure: NSAIDS, steroids, certain nasal drops, certain nasal sprays, certain cough medicines, certain eye drops, certain appetite suppressants and contraception
- The excessive consumption of licorice can result in an increase in blood pressure
- Some studies indicate that poor alignment of a part of the spine called that atlas vertebrae can result in an increase in blood pressure
- High alcohol, high salt diet, lack of exercise, obesity and stress consumption can contribute to high blood pressure
- Smoking, high fat diet, high blood cholesterol and diabetes can exacerbate hypertension
Other Notes On Misdiagnosis Of Hypertension
- Hypertension measurement classification:
- Systolic blood pressure is >140 mmHg - hypertension
- Diastolic blood pressure is >90 mmHg - hypertension
- Systolic blood pressure is 120-139 mmHg - prehypertension
- Diastolic blood pressure is 80-89 mmHg - prehypertension
- Systolic blood pressure is <120 mmHg - normal
- Diastolic blood pressure is <80 mmHg - normal
- Some studies indicate that a healthy blood pressure reading should actually be 115/75 mmHg or lower
- Blood pressures over 130/80 mmHg is considered high in people with diabetes mellitus or kidney disease
- Because blood pressure fluctuates so readily, it is recommended that blood pressure measurements be taken at least three times with each reading being at least one week apart
- An ophthalmoscopic examination of the retina can reveal swelling of the eye nerve caused by hypertension
- Small retinal hemorrhages can be caused by high blood pressure
- Any patient taking blood pressure medication should not make any sudden changes unless speaking to their doctor first
- Certain races face a greater risk of hypertension e.g. African Americans
Medical news summaries about misdiagnosis of Hypertension:
The following medical news items
are relevant to misdiagnosis of Hypertension:
General Misdiagnosis Articles
Read these general articles with an overview of misdiagnosis issues.
About misdiagnosis:
When checking for a misdiagnosis of Hypertension
or confirming a diagnosis of Hypertension,
it is useful to consider what other
medical conditions might be possible misdiagnoses or other alternative
conditions relevant to diagnosis.
These alternate diagnoses of Hypertension may already have
been considered by your doctor or may need to be considered as possible
alternative diagnoses or candidates for misdiagnosis of Hypertension.
For a general overview of misdiagnosis issues for all diseases,
see Overview of Misdiagnosis.
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