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A 27-year-old woman presented to her primary care physician complaining of severe headaches. She was a nonsmoker and denied palpitations, chest pain, or a history of migraines or other severe headache. On physical examination, her blood pressure was found to be 175/125 mm Hg, and her pulse was 74 beats per minute and regular. Follow-up examination revealed persistent poorly controlled blood pressure, and she was started on a calcium channel blocker for better control of her elevated blood pressure. Despite treatment, her blood pressure remained elevated, varying from 140 to 150/80 to 90 mm Hg. Her diagnostic evaluation included a search for secondary causes of the hypertension. Urinary metanephrine levels were within the normal range. A magnetic resonance imaging study, performed to evaluate for renal artery stenosis, revealed a 2.3-cm enhancing mass in the right kidney. Because of enhancement on the radiographic evaluation and inability to rule out carcinoma, radical nephrectomy was p

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A 27-year-old woman presented to her primary care physician complaining of severe headaches. She was a nonsmoker and denied palpitations, chest pain, or a history of migraines or other severe headache. On physical examination, her blood pressure was found to be 175/125 mm Hg, and her pulse was 74 beats per minute and regular. Follow-up examination revealed persistent poorly controlled blood pressure, and she was started on a calcium channel blocker for better control of her elevated blood pressure. Despite treatment, her blood pressure remained elevated, varying from 140 to 150/80 to 90 mm Hg. Her diagnostic evaluation included a search for secondary causes of the hypertension. Urinary metanephrine levels were within the normal range. A magnetic resonance imaging study, performed to evaluate for renal artery stenosis, revealed a 2.3-cm enhancing mass in the right kidney. Because of enhancement on the radiographic evaluation and inability to rule out carcinoma, radical nephrectomy was p

Keywords

MedicineBlood pressurePalpitationsNephrectomyHeadachesPopulationPhysical examinationUrology

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