WHAT COULD BE WRONG???

[blackscrubs]

Ok fellow nurses, I need you to help me out! My brother is 19 and very healthy male. Not overweight, doesn't drink or smoke. He does dip, though. Back in February, he had episodes of blurred vision, headaches, chest pains, and high blood pressure. He went to the Dr. and they treated him for pleurisy. Dr. said he may have anxiety as well. He took the meds he gave him and went on. He never did feel better. He was working in Montana and had to be rushed to the ER due to blood pressure of 177/108. ER doc put him on 10 mg lisinopril. He came home 2 days later. He had to be rushed back to the ER for chest pains, headache at the back of his head, BP 220/154, nausea, and pale skin. ER doc put him on bp meds given IV and still could not get it below 188/114. His BNP was 237 on May 11th and on May 13th had went up to 357. D Dimer is 437, PT is elevated. CT of head was done with contrast and showed nothing. Chest ct was done without contrast and showed some early signs of CHF. He has had an echo, renal ultrasound and abdominal and pelvic cts and all show nothing. His blood pressure is 40 pts higher in lower extremities. They now have him on 4 blood pressure meds and xanax TID and blood pressure will still spike up tp 160/100s. When he stands or walks he gets chest pain and has the headache at the back of his head continuously. I think I have an idea of what it may be. I want to hear your input. The dr said he may just have high blood pressure!! Uhhhh...I am not buying that! Please help me!!!!

[sirI, MSN, APRN, NP]

We know you must be very anxious and scared about your brother. That's understandable, but we cannot offer any input about dx as this is against the TOS regarding medical advice.

Please, stay in close contact with your brother and urge him to continue with his present providers or seek another opinion.

We certainly hope that all can be safely managed with excellent outcome.