…signs of acute organ damage or failure. Any of the drugs listed below may be used to treat hypertensive emergencies. The desired time to action…

…non invasive ventilation or intubation. Aortic disease An acute aortic dissection is a hypertensive emergency requiring the most rapid BP response. The objective is to…

…signs of acute organ damage or failure. Any of the drugs listed below may be used to treat hypertensive emergencies. The desired time to action…

…or treatment with sodium nitroprusside. In most hypertensive emergencies the following is aimed for: 1. Lower the mean arterial pressure by no more than about…

…crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing or new organ damage in which immediate, controlled blood pressure…

…nitroglycerin, nitroprusside, and nicardipine in hypertensive emergencies. Time to onset of action 2 4 minutes Duration of action 5 15 minutes Delivery IV (infusion). Dose…

…Bronchospasm. Caution • Avoided in hypertensive emergencies with left ventricular failure (due to negative inotropic effect). • Used cautiously in patients with asthma (due to risk of…

…Edema. Dizziness. Caution Should be used cautiously in patients with myocardial ischemia and/or heart failure. Nicardipine doses and administration in hypertension (hypertensive crisis/emergency).

Cardiology Emergency medicine Procedurer Definition and Pathophysiology Cardiac tamponade is a life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs…

…effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute left ventricular failure. Mechanism…

Fenoldopam Drug Fenoldopam Brand names Corlopam ® Indications Short term management of hypertension, including hypertensive emergency. Mechanism of action • Systemic Dopamine 1 (D1) receptor agonist…

…conditions, including myocarditis, rapid ventricular rate atrial fibrillation, marked anaemia, hypertensive emergency, heart failure, and end stage renal disease, may produce elevated troponin concentrations. The…

Hydralazine Hydralazine is not preferred for hypertensive emergencies due to the high risk of reflex sympathetic stimulation. Drug Hydralazine Brand names Apresoline ®, Bidil ®…

Esmolol Drug Esmolol Brand names Brevibloc ® Indications Short term control of ventricular rate (including perioperative tachycardia) and hypertension (including hypertensive emergency, perioperative hypertension). Mechanism…

…Duraclon ®, Kapvay ® Indications • Agitated delirium • Analgesia • Hypertension, hypertensive crisis/emergency Mechanism of action Clonidine is primarily a centrally acting alpha 2 agonist. Stimulation…

…not be given to pregnant women. • Should not be given to patients with Leber optic atrophy. Nitroprusside doses and administration in hypertension (hypertensive crisis/emergency).

…hypertension associated with pheochromocytoma; treatment of dermal necrosis after extravasation of drugs with á adrenergic effects. Phentolamine doses and administration in hypertension (hypertensive crisis/emergency…

…Flushing. Palpitations. Tolerance with prolonged use. Methemoglobinemia. Hypoxemia. Caution Proceed with caution in afterload dependent conditions. Nitroglycerin doses and administration in hypertension (hypertensive crisis/emergency).

…Paresthesias (scalp tingling). Bronchospasm. Caution • Avoided in hypertensive emergencies with acute heart failure. • Used cautiously in patients with asthma (due to risk of bronchospasm). • Used…

…increase. Hypertensive crisis Hypertensive urgency: markedly raised pressure without organ involvement — lower it orally over days. Hypertensive emergency: raised pressure with acute organ damage (encephalopathy…

…as indications for additional postural assessment and as factors influencing treatment targets. Blood pressure ≥180/110 mmHg requires assessment for hypertensive emergency. In that setting…

…rising lactate, acidosis, hypertension and tachycardia are common during a generalised seizure. In prolonged status the initial sympathetic response can give way to hypotension, hypoxia…

…individuals with hypertension, diabetes or previous angina. Patients should be advised to seek emergency medical assistance rather than self presenting to an emergency department or…

Emergency medicine Lathundar Differential Diagnosis of Chest Pain: A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome…

Emergency medicine Myocardial ischemia and infarction Definition and pathophysiology Right ventricular infarction (RVI) is myocardial necrosis involving the right ventricle, most often occurring in association…

Cardiology Emergency medicine Definition and Pathophysiology Acute aortic syndromes comprise classic aortic dissection, intramural haematoma (IMH), and penetrating atherosclerotic ulcer (PAU). Aortic dissection accounts for…

Cardiology Emergency medicine Surgery & trauma Definition and Pathophysiology Aortic dissection is a major form of acute aortic syndrome (AAS), alongside intramural haematoma, penetrating atherosclerotic ulcer…

…No effect on CO. Ventricular arrhythmias Cardiac ischemia Hypertension Hypotension Phenylephrine Typically used as emergency bolus to correct acute hypotension. Hypotension (any) Used to increase…

…Definition and Pathophysiology Angiotensin converting enzyme (ACE) inhibitors are foundational therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease…

…No effect on CO. Ventricular arrhythmias Cardiac ischemia Hypertension Hypotension Phenylephrine Typically used as emergency bolus to correct acute hypotension. Hypotension (any) Used to increase…

…chest pain: differential diagnoses, evaluation and management Chest pain is one of the most common symptoms in the emergency department, as well as in primary…

…pulmonary embolism, pulmonary hypertension, septum defects, etc. Right ventricular load is thus an issue that is raised both in outpatient and emergency care. To evaluate…

…and inotropic effects (Figure 1). What follows is a quick reference for their use in the emergency department, the intensive care or coronary care unit…

…systolic dysfunction. Levels may also rise with: Left ventricular diastolic dysfunction Valvular heart disease Pulmonary hypertension Ischaemic heart disease Atrial arrhythmias Pericardial disease, including constriction…

…venous thrombosis – due to risk of embolization Relative contraindications for exercise ECG Severe hypertension (systolic blood pressure 200 mmHg or diastolic blood pressure 110 mmHg)…

…functional capacity Reduce disability and rehospitalization Improve quality of life and self efficacy Address modifiable cardiovascular risk factors Support smoking cessation Improve management of hypertension…

…approach to cardiovascular prevention. Cardiovascular Prevention Across the Life Course Primordial prevention Primordial prevention seeks to prevent the emergence of risk factors. It includes maintenance…

…obesity. Gestational hypertension is defined in the supplied guideline material as blood pressure 140/90 mmHg on two separate occasions after 20 weeks of gestation…

…and depression are more common in women. Dyslipidaemia, hypertension, diabetes and obesity become increasingly prevalent after the menopausal transition. Women with type 2 diabetes also…

…respiratory failure, severe anaemia, sustained bradyarrhythmia Increased myocardial oxygen demand Sustained tachyarrhythmia, severe hypertension, hypertensive crisis, critical aortic stenosis, severe hypertrophic cardiomyopathy, extreme exercise Direct…

…potassium, and resistant to suppression by sodium loading. It is the most common form of secondary hypertension. Aldosterone acts principally through the mineralocorticoid receptor (MR)…

…diabetes mellitus, and metabolic syndrome [58] . Hypertension and coronary artery disease (CAD) remain the most potent population attributable risk factors. Furthermore, the "obesity paradox"—whereby…

Cardiology Pharmacology & dosing Definition and Therapeutic Rationale Hypertension is a major risk factor for atherosclerotic cardiovascular disease and contributes to microvascular and macrovascular complications. It…

…However, a growing body of science suggests that essential hypertension is a multifactorial disease caused by a complex interplay between genes and environment. Industrialization and…

Cardiology Respiratory medicine Definition and Pathophysiology Pulmonary hypertension (PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise…

Cardiology Definition and Pathophysiology Resistant hypertension is a clinical indicator rather than a distinct disease. It identifies patients whose blood pressure remains uncontrolled despite intensive…

…apparent treatment resistance. The diagnosis is clinically important because secondary hypertension may be curable when its cause is clearly established and removed. Cure is not…

Calculators CHA2DS2 VASc Score Calculator Congestive Heart Failure Hypertension Age = 75 years Diabetes Mellitus Stroke/TIA/TE Vascular disease Age 65 74 years Sex…

… 2. Is there cirrhosis, or another strong suspicion of portal hypertension? Variceal and ulcer bleeding are managed differently from the first minute. Peptic ulcer remains…

…effects on the cardiovascular system. Acute exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias…

…of cardiovascular disease (CVD), cardiovascular risk factor clustering, disability and premature mortality. Cardiovascular conditions associated with obesity include hypertension, dyslipidaemia, coronary artery disease (CAD), atherosclerosis…

…structurally and functionally altered, and the pathological changes are not explained by coronary heart disease, hypertension, valvular disease or congenital heart disease. Cardiomyopathy leads to…

…to the reduced area of the valvular orifice. Both aortic stenosis and hypertension result in increased ventricular load, which the ventricle counteracts by developing hypertrophy…

…artery into the right ventricle during diastole. The most common cause of abnormal pulmonary regurgitation is pulmonary hypertension. Table 1 presents the causes of pulmonary…

…sweating, anxiety, insomnia, tachycardia, hypertension, headache, nausea and vomiting 8 to 24 hours Alcoholic hallucinosis, often visual, auditory or tactile hallucinations with a relatively clear…

…abnormal 24 hour rhythm should prompt investigation for sleep apnoea, renal disease and secondary hypertension, and lead to one dose being moved to the evening…

… higher in known hypertension Pulse pressure 40–60 mmHg A narrow pulse pressure suggests a low stroke volume Capillary refill < 3 s A simple…

…Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg/h…

…tau). Measurement of the opening pressure in suspected idiopathic intracranial hypertension. Therapeutic drainage in idiopathic intracranial hypertension and in assessment before shunt surgery. Contraindications Clinical…

…fetal bleeding respectively). Marked liver failure with coagulopathy. Severe uncontrolled hypertension. Recent intracranial haemorrhage without a fresh assessment of benefit and risk. An inability to…