Episode 41: Hypertensive Emergencies
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Mar 24, 2014 Dr. Joel Yaphe, an EM residency program director and expert in hypertensive emergencies, joins Dr. Clare Atzema, a leading cardiovascular EM researcher. They delve into the complexities of managing hypertensive emergencies like aortic dissection and hypertensive encephalopathy. The discussion highlights the urgency of individualized care strategies and the importance of careful blood pressure management. They also cover the latest treatment protocols for conditions such as preeclampsia and emphasize the critical evaluation of diagnostic approaches in emergency settings.
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Hypertensive Emergency Pathophysiology
- Hypertensive emergencies are a diverse group of disorders with varying pathophysiologies.
- They can be categorized into microvascular and macrocirculatory issues.
Suspecting Hypertensive Encephalopathy
- Suspect hypertensive encephalopathy in patients with hypertension history, altered mental status, and severe hypertension.
- Obtain a negative CT scan before treatment to rule out other causes.
General Principles of IV Antihypertensives
- Avoid rapid blood pressure reduction except in aortic dissection to prevent ischemia.
- Target a 25% reduction maximum and address the underlying cause of end-organ damage.