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.
25% in the first hour
- Arterial Vasodilation
- SCAPE Podcast
- Treatment of Aortic Dissection
ICH or TBI
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
Want More Info?
- Great Htn Review Article from Paul Marik
- Fantastic post from the Strayer
- Long-Term follow-up shows hypertension in ED pts doesn't predict adverse outcome [Elevated Blood Pressures Are Common in the Emergency Department but Are They Important? A Retrospective Cohort Study of 30,278 Adults. Ann Emerg Med. 2021 Feb 9;S0196-0644(20)31363-9. doi: 10.1016/j.annemergmed.2020.11.
Now on to the Podcast…
- EMCrit 303 – A Bounceback Case with Mike Weinstock - July 23, 2021
- EMCrit 302 – Pain Management Update with Sergey Motov - July 15, 2021
- EMCrit 301 – The Five Fears with Rob Orman (Mind of the Resuscitationist) - July 1, 2021