Dr. Chapa’s Clinical Pearls. Severe CHTN or Superimposed PreE w/Severe Features?
Feb 6, 2025
The podcast dives into the complexities of diagnosing severe hypertension in pregnant women, dissecting the tricky distinction between chronic hypertension and superimposed preeclampsia. Listeners learn about the significance of specific blood pressure thresholds and the risks of misclassification. The discussion emphasizes the importance of adhering to clinical guidelines for optimal maternal and fetal health. It also explores the challenges in interpreting blood pressure readings and the need for vigilance in treatment strategies.
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Patient Case
- Dr. Chapa discusses a patient with chronic hypertension and severe blood pressures (160/110).
- She requires escalating doses of medication but shows no other concerning symptoms or lab abnormalities.
Diagnostic Dilemma
- A key question is whether severe blood pressure in chronic hypertension is simply an exacerbation or superimposed preeclampsia.
- Gestational hypertension at 160/110 is preeclampsia with severe features, raising the question about chronic hypertension.
Severe Hypertension as Superimposed Preeclampsia?
- Reaching 160/110 with chronic hypertension raises the question of superimposed preeclampsia with severe features.
- ACOG provides guidance, but it's unclear, described as "clear as mud."