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THE DIAGNOSIS OF 'TETANY' BONUS OF BP EXAMINATION
IN YOUNG INDIAN FEMALES
O P Kapoor
Hon. Visiting Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
Very often one is tempted to omit examination of BP in young female patients and correctly so. Low BP in an ambulatory patient presenting in a clinic is more or less always a wrong diagnosis.Essential hypertension hardly ever occurs in such patients. Very rarely they can have severe secondary hypertension in which case an enlarged heart and a loud second heart sound in the aortic area can point towards diagnosis of hypertension. However it is always good to check BP in young female patients.
"Carpal Spasm" in the hand while recording BP is bonus. It is good to remember that in such patients, you should keep the BP cuff inflated for a few seconds and go on looking at the hand. This carpal spasm is diagnostic of tetany without testing serum calcium or alkaline phosphatase levels.
Often these patients have multiple complaints. These include numbness of limbs and cramps. While taking history, an average practitioner does not even register, these complaints or attach any importance to them.
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