End organ damage

End organ damage usually refers to damage occurring in major organs fed by the circulatory system (heart, kidneys, brain, eyes) which can sustain damage due to uncontrolled hypertension, hypotension, or hypovolemia.

Evidence of hypertensive damage

In the context of hypertension features looked for, at least in the initial work-up, include:[1]

• Heart - evidence on electrocardiogram screening[1] of the heart muscle thickening up (but may also be seen on chest X-ray) suggesting left ventricular hypertrophy) or by echocardiography of less efficient function (left ventricular failure).
• Brain-Also you can see hypertensive Encephalopathy, CVA hemorrhagic stroke,Subarcnid hemorrhage, confusion, Loss of consciousness, Eclampsia,Seizures and Transient is ischemic attack.
• Kidney - the presence of leakage of protein into the urine (albuminuria or proteinuria), or reduced renal function.[1] you can see Hypertensive nephropathy,Acut renal failure, glomerulonephritis and proteinuria.
• Eye - evidence upon fundoscopic examination of hypertensive retinopathy.[1] Retinal hemorrhage, retinal papilledema and blindness.
• Peripheral Arteries- Peripheral vascular disease and chronic lower limb ischemia.

Evidence of shock (poor end organ perfusion)

• Kidney - poor urine output (less than 0/5mL/kg), low GFR.
• Skin - pallor or mottled appearance, capillary refill > 2secs, cool peripheries.
• Brain - orientation to time, person, and place. The GCS may be used to quantify altered consciousness if this is present.

References

1. "CG34 Hypertension - quick reference guide" (PDF). National Institute for Health and Clinical Excellence. 28 June 2006. Archived from the original (PDF) on 2009-03-13. Retrieved 2009-03-04.