Acute symptoms · Berlin
Hypertensive crisis
Hypertensive crisis is an acute medical condition that RAB Arztbesuche treats with a licensed physician on a home visit anywhere in Berlin — daily from 6 am to midnight, usually within 60 to 90 minutes.
A blood pressure of 200/110, headache, nosebleeds, chest pressure — a hypertensive crisis can be frightening. The decisive question: hypertensive urgency or hypertensive emergency? Our specialist physicians come daily from 6 am to midnight, measure, run an ECG and decide with you on the right therapy.
Medically reviewed by Susanne Reiche · Last reviewed
Hypertensive crisis in Berlin — the critical distinction
Daily we see patients with home readings over 180/110 mmHg who call us out of worry. In most cases this is hypertensive urgency — markedly raised blood pressure without acute organ damage. It can be managed safely in the outpatient setting. A hypertensive emergency, however — extremely high blood pressure together with acute damage to heart, brain, kidney or aorta — is life-threatening and belongs in hospital.
Making this distinction is the central value of the house call: we come, measure repeatedly under standardised conditions, run a 12-lead ECG, screen neurological function and decide together with you whether outpatient care suffices or whether hospital admission is needed. This triage does not replace the ambulance service for clear emergency signs; it complements it in the more common grey zone.
What happens during the house call
We measure blood pressure in both arms, seated after at least five minutes of rest, and repeat at standardised intervals. A 12-lead ECG captures acute cardiac strain (left-ventricular strain pattern, ST changes, new arrhythmias). We measure oxygen saturation, auscultate heart and lungs, assess general state and run a basic neurological exam. In pure hypertensive urgency we lower the pressure stepwise — usually orally with a fast-acting calcium antagonist or an ACE inhibitor; lowering too fast can do harm. We then refine the long-term regimen with you and arrange a prompt GP follow-up.
Why long-term control is the real lever
A single hypertensive crisis can be treated acutely — the real issue is usually inadequate long-term control. We review existing medication, ask about adherence, lifestyle, salt intake and sleep patterns and put a realistic plan in place. Where indicated we arrange 24-hour blood pressure monitoring, an echocardiogram or labs for secondary cause work-up. We connect with your GP with a written report.
How the house call works
On first contact we clarify values, accompanying symptoms (headache, chest pain, breathlessness, neurological deficits), existing diagnoses and medication. With clear emergency signs we direct you to 112 or straight to hospital; otherwise we dispatch the next available specialist — typically a 60- to 90-minute arrival.
On site we measure in structured fashion, record an ECG, examine you and discuss findings. In pure urgency we start controlled oral lowering and stay for the first 30 to 60 minutes for monitoring. You receive clear written escalation criteria and a follow-up plan.
Billing and insurance
We bill according to the German private medical fee schedule (GOÄ) via our Privatärztliche Verrechnungsstelle. House call, internal medicine exam, ECG, administered medication and consumables are itemised separately. German private health insurance and Beihilfe schemes typically reimburse these positions in full.
We can issue an English invoice on request and remain reachable by phone for billing questions after the visit.
Emergency? Dial the emergency number
If unconscious, with severe chest pain, breathlessness or heavy bleeding, dial 112 immediately. Our service complements the emergency services — it does not replace them.
Case profiles
Typical scenarios
Home reading 210/115 without symptoms
A patient in Wilmersdorf repeatedly measures very high values at home but feels unwell. We come, confirm under standardised conditions, run an ECG and start controlled lowering.
Headache and nosebleed with hypertension
A patient in Pankow has severe headache and nosebleed for hours at 200/110. We assess whether this is pure urgency or whether neurological signs warrant hospital admission.
Known hypertension, decompensation under stress
A business traveller in a Mitte hotel develops high values under stress. We lower controlled and adjust medication for the trip.
Older patient with new atrial fibrillation
In a 78-year-old in Zehlendorf the ECG shows new atrial fibrillation alongside hypertension. We direct to cardiology for further work-up.
Frequently asked questions
From which value should I call?
Values above 180/110 mmHg at rest should be assessed medically — especially with symptoms like headache, chest pain, breathlessness or neurological deficits. For clear emergency signs, 112 is the right call.
Can the doctor give me something immediately?
Yes. In hypertensive urgency we start controlled oral therapy, usually with a fast-acting calcium antagonist. We stay for the first 30 to 60 minutes to monitor.
Why not just lower the blood pressure very quickly?
Lowering too fast can cause harm — brain perfusion, kidney and heart react sensitively. Stepwise lowering over several hours is the safe approach in pure urgency.
Will I need cardiology follow-up afterwards?
In most cases yes. We arrange or recommend 24-hour BP monitoring, echocardiogram and labs for secondary cause work-up.
Book now or call
Get in touch — we will arrange a doctor for your house call regarding Hypertensive crisis.