A Case of Complete Heart Block Presenting as Resistant Hypertensive Emergency

Abstract

The nationally accepted guideline for hypertension is an elevated systolic and diastolic reading of >130/80. Unmanaged hypertension could eventually lead to hypertensive urgency if a patient’s blood pressure is >180/100 with no signs of organ damage, or hypertensive emergency if their blood pressure is >180/100 and there are signs of organ damage occurring. When a patient presents with hypertensive emergency that is difficult to control despite multiple antihypertensives, this is known as resistant hypertension. Persistently resistant hypertension can also be described as refractory hypertension. Here, we have an African-American gentleman who presented with bradycardia and hypertensive emergency that was refractory to medical therapies. Subsequently, it was found that he was in complete heart block. His blood pressure only improved two weeks after pacemaker implantation and required multiple antihypertensives.