Physical Examination

After confirming that the BP is elevated, the physical examination is primarily directed to identifying any end organ damage, which will define a hypertensive emergency in this context.

The physical examination may also help determine (if its not already known) the underlying cause of hypertension, e.g. markedly reduced femoral pulses in coarctation.

It is important to accurately determine the BP so that trends over time and in response to therapy can be gauged. BP should be assessed (with an appropriately sized cuff) in both upper limbs, evaluating whether there is any discrepancy between the limbs. A thorough cardiovascular and neurological examination is essential if end organ dysfunction is to be identified.

This table outlines the physical examination required to determine end organ damage.