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Warning-sign checks

Malignant hypertension: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services if a very high blood pressure reading occurs with:

    • Chest pain, severe breathlessness, or fainting
    • New weakness, numbness, facial drooping, or trouble speaking
    • Confusion, a seizure, or difficulty staying awake
    • Sudden loss of vision or major visual change
    • A sudden, severe headache unlike your usual headaches
    • Sudden severe chest, back, or abdominal pain
    • Pregnancy with severe headache, visual symptoms, or upper abdominal pain

    Do not take extra blood pressure medicine unless emergency professionals specifically advise it.

    A reading of 180/120 mmHg or higher without emergency symptoms is not automatically malignant hypertension, but it should not be ignored.

    Routine follow-up is appropriate for medication reviews, home readings that are gradually rising but remain below crisis levels, or mild side effects without emergency symptoms.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Sit quietly, check the reading again with correct technique, and seek prompt medical advice.

    Follow the urgent-care instructions available where you live.

  3. 3

    Does any of this apply?

    Book an appointment

    Arrange an earlier review if readings repeatedly remain above the target set for you.

The article also says

Do not drive yourself if you have these symptoms.

Every sign above is quoted from the sofidex article on Malignant hypertension. If you are not sure, err upward — it is always reasonable to be checked.