Renal hypertension

a 27 yr old pat c/o heavyness over head bluring of vision occ sev headche and cloudiness for last one month bp 210/130 mmhg afrbrile renal doplr and kub usg attached plz gv ur expert advice Chief Complaints blurred vision heavyness over head History no f/o htn dm Vitals temp 98 bp 210/130

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Pt is a c/o malignant hypertension with gr1 renal parenchymal disease Intresting finding renal artherosclerosis as per renal doppler in pt of age 27yrs indicates hypercholesterolemia or dyslipidimia Complaints of blurring of vision heaviness cloudiness suggest central manifestations Hence needs MRI brain with MRA Also go for sr cholestrol tg hdl and lipid profile Ecg 2decho Gradually lower the bp Tab telmisartan+chlorthalidone 40mg+12.5 mg Tab ecosprin 150mg 1od Rest of advise with complete investigations

Thank you doctor
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First try to tackle this hypertensive emergency condition Give tab: Nitroglycerin 2.5 Inj Lobet 40 Check for bp fall Then send him to nearest Emergency center For better opinion may he need surgical intervention to remove clot

pat being rfd to renal arteriograpy thanks