Rapid Decrease in Blood Pressure in Hypertensive Patient Leads to Stroke

Cody Porcoro

Written by
on October 31, 2017

This case involves a 57-year-old man with a history of high blood pressure who presented to the emergency room with chest pain and hypertensive urgency. At intake, his blood pressure was over 200 systolic and was rapidly lowered within a 5 hour period. However, he suffered a stroke almost immediately afterwards. Although he slowly recovered, he remained in a comatose state for over a week and suffered dysphasia.

Question(s) For Expert Witness

  • 1. How often do you treat patients with blood pressures over 200 systolic?
  • 2. What is the standard of care for lowering blood pressure in a patient with chest pain?
  • 3. Have you ever had a patient develop this complication?
  • 4. Have you ever reviewed a similar case? If yes, please elaborate.

Expert Witness Response E-065721

I treat patients like this very often, on a weekly basis. The standard of care in a case like this is to lower the blood pressure to relieve the patient’s symptoms, but not too aggressively to cause harm to the patient. I have never treated a patient that experienced a complication such as this (a stroke).

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