Hypertensive crisis: Difference between revisions

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== Definition ==
==Definition==


* Emergency if BP >180/120 associated with new or worsening target organ damage
*Emergency if BP >180/120 associated with new or worsening target organ damage
* Urgency if stable without target organ damage; they can be managed as outpatients
*Urgency if stable without target organ damage; they can be managed as outpatients


== Management ==
==Management==


=== Acute Care ===
===Acute Care===


==== Target ====
====Target====


* If aortic dissection, severe preeclampsia, pheo crisis: lower to <140 within the first hour
*If [[aortic dissection]], severe [[preeclampsia]], [[pheochromocytoma]] crisis: lower to <140 within the first hour
** Or to <120 for aortic dissection
**Or to <120 for aortic dissection
* Otherwise: decrease by no more than 25% in first hour, then to 160/100 over the next 6 hours, then to normal over next day
*Otherwise: decrease by no more than 25% in first hour, then to 160/100 over the next 6 hours, then to normal over next day


==== Pharmacotherapy ====
====Pharmacotherapy====


* Labetalol
*[[Labetalol]]
** Preferred for aortic dissection and acute MI
**Preferred for aortic dissection and acute MI
* Sodium nitroprusside or nitroglycerin
*Sodium [[nitroprusside]] or [[nitroglycerin]]
* Hydralazine
*[[Hydralazine]]
* Nicardipine and enalaprilat, if you can find them
*[[Nicardipine]] and [[enalaprilat]], if you can find them


[[Category:Cardiology]]
[[Category:Cardiology]]

Latest revision as of 14:10, 2 August 2020

Definition

  • Emergency if BP >180/120 associated with new or worsening target organ damage
  • Urgency if stable without target organ damage; they can be managed as outpatients

Management

Acute Care

Target

  • If aortic dissection, severe preeclampsia, pheochromocytoma crisis: lower to <140 within the first hour
    • Or to <120 for aortic dissection
  • Otherwise: decrease by no more than 25% in first hour, then to 160/100 over the next 6 hours, then to normal over next day

Pharmacotherapy