Hypertensive crisis: Difference between revisions
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− | == |
+ | ==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==== |
− | * |
+ | *[[Labetalol]] |
− | ** |
+ | **Preferred for aortic dissection and acute MI |
− | * |
+ | *Sodium [[nitroprusside]] or [[nitroglycerin]] |
− | * |
+ | *[[Hydralazine]] |
− | * |
+ | *[[Nicardipine]] and [[enalaprilat]], if you can find them |
[[Category:Cardiology]] |
[[Category:Cardiology]] |
Latest revision as of 10:10, 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
- Labetalol
- Preferred for aortic dissection and acute MI
- Sodium nitroprusside or nitroglycerin
- Hydralazine
- Nicardipine and enalaprilat, if you can find them