Table 3.

Clinical examination in a child or adolescent with elevated blood pressure or hypertension.

- Height, weight and BMI

- Morphological examination:

* Check for dysmorphic facial features (Turner's syndrome, elfin-like facial features of Williams-Beuren syndrome, Alagille syndrome, etc.);

* Café au lait spots (neurofibromatosis), sebaceous adenomas (tuberous sclerosis), angiomas (Von Hippel-Lindau disease);

* Check for arachnid morphology and joint hypermobility (Marfan syndrome) and/or pseudoxanthoma elasticum;

* Check for exophthalmos, for a goitre; (hyperthyroidism);

* Check for the moon face of Cushing's syndrome, stretch marks (hypercortisolism)

- Cardiovascular examination:

* Measure BP in the 4 limbs;

* Check for and auscultate superficial pulses (coarctation of the aorta);

* Check for a heart murmur and abdominal (renal artery stenosis), carotid and femoral bruits;

* Check for signs of heart failure.

- Abdominal examination

* Check for masses (Wilms' tumour, neuroblastoma, autosomal dominant or recessive polycystic kidney disease);

* Check for hepatosplenomegaly (autosomal recessive polycystic kidney disease).

- Neurological examination with an ocular fundus (Alagille syndrome).

BP, blood pressure.