Question

Steve, age 42, has never been hypertensive but appears today in the office with a blood pressure of 162/100 mm Hg. He also complains of 'attacks' of headache, perspiration, and palpitations, with frequent bouts of nausea, pain, weakness, dyspnea, and visual disturbances. He has lost 10 lb over the past 2 months and seems very anxious today. Your next action would be to:

1) Start him on an antianxiety agent.
2) Obtain a 24-hour urine test for catecholamines.
3) Start him on a diuretic or beta blocker.
4) Recheck his blood pressure in 1 week.

Answer 1

The next action you should take for Steve would be to obtain a 24-hour urine test for catecholamines to determine the underlying cause of his symptoms and high blood pressure.

Step-by-step explanation:

The next action you should take for Steve, who has never been hypertensive but now presents with a blood pressure of 162/100 mm Hg, along with various symptoms such as headache, perspiration, palpitations, nausea, pain, weakness, dyspnea, and visual disturbances, would be to obtain a 24-hour urine test for catecholamines. This test can help determine if his symptoms are caused by excessive production of catecholamines, which are hormones that can increase blood pressure. By identifying the underlying cause, further treatment can be recommended.