Our patient is an 19-year-old man referred for evaluation of hypertension discovered on a routine physical examination.
The pertinent features of his history include a heart murmur noted during infancy, with no further evaluation. He demonstrated normal growth and development with minimal medical care since infancy. He underwent routine pre-employment examination recently revealing systemic hypertension. Previous blood pressure unknown.
There is no history of palpitations, significant chest pain, shortness of breath, cyanosis, syncope, or rheumatic fever.
The patient smokes one pack of cigarettes per day, uses alcohol moderately, but denies illicit drugs. He has no regular exercise program. There is no family history of congenital heart disease or early age heart attack. History of hypertension in the family is unknown.