The first thing to understand about Hypertensive Emergencies is that they look like emergencies

The second thing is in the short term, the only way to really fuck up non-emergent hypertension is by acutely lowering it too much

Hypertensive emergencies, hypertensive urgencies, markedly elevated blood pressure–ugggh! Hypertension is a real annoyance in emergency medicine. Folks get scared of numbers and encourage dangerous behavior because of them. It's a bit better in the ICU, where there is a filter to keep out non-emergent hypertension cases. “Hypertensive Emergencies” are a whole different bag. In these conditions, the hypertension is usually secondary to the actual emergency. So I prefer to call these emergencies with a side of hypertension.

Treatment Priorities

25% in the first hour

Pain

Inotropy/Chronotropy

Arterial Vasodilation

The Meds

Labetalol

Esmolol

Nitroglycerin

Nitroprusside

Nicardipine

Clevidipine

Fenoldopam

Hydralazine Sucks

The Emergencies

ACS

SCAPE

SCAPE Podcast

Aortic Dissection/AAA

Treatment of Aortic Dissection

Ischemic Stroke

ICH or TBI

aSAH

PreEclampsia/Eclampsia

Hypertensive Encephalopathy/Malignant Hypertension

a headache is not a hypertensive emergency unless the patient looks so bad that you are rushing her to CT

Usually (but not always) will have papilledema

Visual Changes, AMS, Confusion, Severe Headache, Coma

Tox

Sympathomimetic OD

MAO Inhibitors

Pheo

Acute Glomerulonephritis

Thyroid Storm

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