Hypertensive Emergency with Sudden Subconjunctival Hemorrhage, Chronic Kidney Failure, and Hypertensive Retinopathy in Breast Cancer Survivor: Case Report

Coana Sukmagautama, Agni Shalha Ali, Aiman Hilmi Asaduddin, Ummu Ma’rifatul Afifah

Abstract

Introduction: Hypertensive emergency is a life-threatening condition of very high blood pressure associated with acute end-organ damage that requires appropriate therapy to treat progressive organ dysfunction.

Case presentation: 44-years-old breast cancer survivor woman with severe hypertension and sudden left eye bleeding. The blood pressure was 213/115 mmHg. The patient also had chronic kidney failure and hypertensive retinopathy as hypertension complications. The laboratory examination showed an abnormal lipid profile and the presence of proteinuria and bacteriuria from the urinalysis.

Discussion and conclusion: Subconjunctival hemorrhage (SCH) presentation can indicate any serious underlying etiology that needs prompt treatment as in this patient requiring further evaluations. Aggressive treatment was given to reduce blood pressure and further observations for SCH.

Keywords: hypertension; subconjunctival hemorrhage; chronic kidney failure; hypertensive retinopathy

Keywords

Hypertension; Subconjunctival hemorrhage; Chronic kidney failure; Hypertensive retinopathy

Full Text:

PDF

References

  1. Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 practice guidelines for the management of arterial hypertension of the European society of cardiology and the European society of hypertension ESC/ESH task force for the management of arterial hypertension. Vol. 36, Journal of Hypertension. 2018. 2284–2309 p.
  2. Rukmini RM, Rajya LM. Study of essential hypertension with special reference to end organ damage in adults. International Journal of Advances in Medicine. 2018;5(5):1227.
  3. I. Oporto J, Velasco R, Mori A, Olivares C. Atypical case of subconjunctival hemorrhage. Gen Intern Med Clin Innov. 2019;4(3):1–2.
  4. Tarlan B, Kiratli H. Subconjunctival hemorrhage: Risk factors and potential indicators. Clin Ophthalmol. 2013;7:1163–70.
  5. Varounis C, Katsi V, Nihoyannopoulos P, Lekakis J, Tousoulis D. Cardiovascular Hypertensive Crisis: Recent Evidence and Review of the Literature. Frontiers in Cardiovascular Medicine. 2017;3(January):1–5.
  6. Doshi R, Noohani T. Subconjunctival Hemorrhage. In: Statpearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.
  7. I. Oporto J, Velasco R, Mori A, Olivares C. Atypical case of subconjunctival hemorrhage. Gen Intern Med Clin Innov. 2019;4(3):1–2.
  8. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):1–150.
  9. S.L. de Vroom, R.M. van Hest, F.V. van Daalen et al., Pharmacokinetic/pharmacodynamic target attainment of ciprofloxacin in adult patients on general wards with adequate and impaired renal function, International Journal of Antimicrobial Agents, International Journal of Antimicrobial Agents, 2020;11:45.
  10. Griffn KA. Hypertensive kidney injury and the progression of chronic kidney disease. Hypertension. 2017;70(4):687–94.
  11. Van Dorst DCH, Dobbin SJH, Neves KB, Herrmann J, Herrmann SM, Versmissen J, et al. Hypertension and Prohypertensive Antineoplastic Therapies in Cancer Patients. Circulation Research. 2021;1040–61.
  12. De Souza VB, Silva EN, Ribeiro ML, De Martins WA. Hypertension in patients with cancer. Arq Bras Cardiol. 2015;104(3):246-252. doi:10.5935/abc.20150011
  13. Saguner AM, Dür S, Perrig M, Schiemann U, Stuck AE, Bürgi U, et al. Risk factors promoting hypertensive crises: Evidence from a longitudinal study. Am J Hypertens [Internet]. 2010;23(7):775–80. Available from: http://dx.doi.org/10.1038/ajh.2010.71.
  14. Benenson I, Waldron F, Jadotte Y, Dreker M, Holly C. Risk factors for hypertensive crisis in adult patients: a systematic review. JBI Evid Synth. 2021 Feb 5;Publish Ah.
  15. Suvila K, Langén V, Cheng S, Niiranen TJ. Age of Hypertension Onset: Overview of Research and How to Apply in Practice. Curr Hypertens Rep. 2020;22(9):15–7.
  16. Suvila K, McCabe EL, Lehtonen A, Ebinger JE, Lima JAC, Cheng S, et al. Early Onset Hypertension Is Associated with Hypertensive End-Organ Damage Already by MidLife. Hypertension. 2019;74(2):305–12.
  17. Lee HA, Park H. Diet-related risk factors for incident hypertension during an 11-year follow-up: The Korean genome epidemiology study. Nutrients. 2018;10(8).
  18. Aronow WS. Treatment of hypertensive emergencies. Annals of Translational Medicine. 2017;5(8):1–4.
  19. Van Den Born BJH, Lip GYH, Brguljan-Hitij J, Cremer A, Segura J, Morales E, et al. ESC Council on hypertension position document on the management of hypertensive emergencies. Eur Hear J - Cardiovasc Pharmacother. 2019;5(1):37–46.

DOI: https://doi.org/10.13057/smj.v5i3.64344

Refbacks

  • There are currently no refbacks.