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Hypertensive emergency — ABEM Board MCQ

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ModerateCardiovascular emergenciesHypertensive emergencyABEM Board

A 59-year-old woman arrives with severe headache, confusion, and blurred vision. Triage acuity is ESI 2; BP 232/126 mm Hg, HR 96/min. Fundoscopy shows papilledema, and creatinine is acutely elevated. She has no focal neurologic deficit and no chest pain. Which of the following is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Hypertensive emergency with encephalopathy

Severe hypertension with acute target-organ injury, including encephalopathy and renal injury, defines hypertensive emergency.

Reference: ACEP Asymptomatic Elevated Blood Pressure clinical policy; AHA hypertension guidance