Conn's syndrome

Syndrome of hypertension and hypokalaemia caused by hyperaldosteronism. A diagnosis of Conn's may be caused by a unilateral adrenal adenoma or bilateral adrenal hyperplasia.

General examination

Detailed and full general examination is mandatory in the initial assessment of all endocrine patients.

Blood pressure in both upper limbs

Elevated BP in one limb only may not have been previously noted.

Peripheral pulses

Absent or weak lower limb pulses are suggestive of coarcation of the aorta.

Cardiorespiratory status

This is mandatory to assess for underlying disease, and to seek evidence of end organ damage and suitability for surgery.

Fundoscopy

Long standing hypertension may cause end organ damage including retinopathy.  

Urinalysis

Long standing hypertension of any cause may cause renal damage. Intrinsic renal disease is also a cause of hypertension.

Thyroid and thyroid status

Thyrotoxicosis is an alternative cause of hypertension and may be associated with hypokalaemia.

Signs of Cushing's syndrome

Cushing's syndrome is an alternative cause of hypertension and hypokalaemia, and may be associated with an adrenal mass.