Hypertensive emergency
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
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Hypertensive emergency | |
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Synonyms | N/A |
Pronounce | N/A |
Specialty | N/A |
Symptoms | Severe headache, chest pain, shortness of breath, nausea, vomiting, confusion, seizures |
Complications | Stroke, myocardial infarction, heart failure, kidney failure, aortic dissection |
Onset | Sudden |
Duration | Variable |
Types | N/A |
Causes | Severe hypertension |
Risks | Chronic hypertension, noncompliance with antihypertensive medications, pheochromocytoma, renal artery stenosis |
Diagnosis | Based on blood pressure measurement and presence of end-organ damage |
Differential diagnosis | Hypertensive urgency, anxiety, panic attack, pheochromocytoma |
Prevention | N/A |
Treatment | Intravenous therapy with antihypertensive medications, hospitalization |
Medication | Nitroprusside, labetalol, nicardipine, esmolol |
Prognosis | Variable, depends on promptness of treatment and severity of complications |
Frequency | Rare |
Deaths | N/A |
Hypertensive emergency is a severe increase in blood pressure that can lead to a stroke. Extremely high blood pressure — a top number (systolic pressure) of 180 millimeters of mercury (mm Hg) or higher or a bottom number (diastolic pressure) of 120 mm Hg or higher — can damage blood vessels. The blood vessels become inflamed and may leak fluid or blood. As a result, the heart may not be able to pump blood effectively.
Causes
Hypertensive emergency can occur in patients with a history of high blood pressure, but it can also occur in those with no history. The exact cause is unknown, but it is often associated with heart failure, heart attack, kidney failure, aortic dissection, or preeclampsia.
Symptoms
Symptoms of hypertensive emergency can include severe headache, severe anxiety, shortness of breath, and nosebleed. However, some people with hypertensive emergency do not experience any symptoms.
Diagnosis
Hypertensive emergency is diagnosed through a physical examination and a review of the patient's medical history. The doctor will also check the patient's blood pressure. If the blood pressure is extremely high, the doctor will check for damage to the body's organs.
Treatment
Treatment for hypertensive emergency aims to reduce blood pressure gradually over a period of hours to days. This is usually done with a combination of medications. The specific medications used depend on the patient's condition and the severity of the hypertensive emergency.
Prevention
Prevention of hypertensive emergency involves managing high blood pressure through lifestyle changes and medication. Regular check-ups with a doctor are also important.
See also
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Contributors: Kondreddy Naveen, Prab R. Tumpati, MD