End organ damage

End organ or target 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).
• Kidney - the presence of leakage of protein into the urine (albuminuria or proteinuria), or reduced renal function.^[1]
• Eye - evidence upon fundoscopic examination of hypertensive retinopathy.^[1]

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. Retrieved 2009-03-04.