Dr Colin Tidy, MRCGP

Blood pressure recording outside of the doctor's surgery is recommended in most people who are suspected of having high blood pressure. This is because readings taken while people are going about their daily lives are more accurate than those taken in a doctor's surgery. They may also be used to give the doctor information about how well a blood pressure medicine is working. The ideal method is ambulatory blood pressure monitoring, which uses a portable recorder. If this is inconvenient or uncomfortable, readings can be taken using a traditional blood pressure machine at home.

Thyroid eye disease causes the muscles and soft tissues within the eye socket to swell. This pushes the eyeball forward and causes various eye symptoms, including bulging eyes. Treatment involves steps to protect the eye as the disease runs its course. This may involve use of eye drops to provide artificial lubricating tears, medicines and, in some cases, surgery. Thyroid eye disease is usually associated with an abnormality of thyroid gland function. This also needs to be treated.

An aortic dissection is a rare, serious condition. The inner layer of the aorta (the biggest blood vessel in the body, coming directly from the heart) tears. Blood then surges through the tear. This causes the inner and middle layers of the aorta to separate (dissect). Aortic dissection is a medical emergency and needs urgent treatment. The treatment for aortic dissection includes an operation to repair the wall of the aorta. Medicines to reduce blood pressure are also used. Aortic dissection is often fatal but early diagnosis and treatment of aortic dissection can greatly improve survival.

Kawasaki disease is a rare condition that affects small to medium-sized blood vessels in the body. Kawasaki disease causes the the walls of the blood vessels to become inflamed and swollen (vasculitis). Kawasaki disease mainly affects children less than 5 years old. The exact cause of Kawasaki disease remains unknown. Kawasaki disease causes a high temperature (fever), a rash, and other typical symptoms (listed below). The most serious complication of Kawasaki disease occurs when the arteries supplying the heart (coronary arteries) are affected. This occurs in about 1 in 4 children with untreated Kawasaki disease. Treatment with intravenous immunoglobulin and aspirin has greatly reduced the proportion of children with Kawasaki disease who develop coronary artery problems. The outcome for children diagnosed with Kawasaki disease is mainly based on the extent and severity of coronary artery involvement. Kawasaki disease is fatal in less than 1 in 500 of those affected.

Hidradenitis suppurativa is a long-term (chronic) skin condition that leads to painful and repeated lumps of pus (boils or abscesses). The exact cause is unknown. Suppuration means formation or discharge of pus. These areas (commonly the armpits and groin) leak pus and are difficult to heal. Eventually, scarring occurs. Treatments include antibiotic lotions or medicines, or an operation to remove the affected skin area. A newer treatment works by blocking a chemical of the immune system that causes inflammation in the body.