![]() ![]() Conditions associated with hypertensive emergencies include hypertensive encephalopathy, acute left ventricular failure with pulmonary edema, acute myocardial infarction, dissecting aortic aneurysm, intracerebral hemorrhage, and eclampsia. ![]() In a hypertensive emergency, the patient's BP must be lowered at once to halt the acute, progressive damage to the target organs. Although the BP is also elevated in a hypertensive urgency, there's little or no evidence of target organ damage. ![]() In a hypertensive emergency, the elevated BP causes target organ damage (brain, eyes, blood vessels, heart, and kidneys). The two types of hypertensive crises- hypertensive emergency and hypertensive urgency- share a common sign: severely elevated BP, usually defined as a diastolic pressure that exceeds 120 mm Hg. Thurgood's soaring BP as quickly as possible. Now let's look at how to safely lower Mr. For more information on the causes of hypertensive crises, see Behind the high rise. Thurgood's case, have abruptly stopped taking their antihypertensive medications. This condition can occur in patients who have poorly controlled hypertension or, as in Mr. Thurgood's history and your assessment findings, you suspect that he's experiencing a hypertensive crisis. But he hasn't taken the drug for 3 weeks because his prescription ran out and he couldn't afford to refill it.īased on Mr. Thurgood tells you that to treat his hypertension, for the last 3 years or so, he's been taking Prinzide, a combination of lisinopril, an angiotensin-converting enzyme (ACE) inhibitor and hydrochlorothiazide, a thiazide-type diuretic. When checking his vital signs, you discover that his blood pressure (BP) is 220/140 mm Hg. Peter Thurgood, 74, arrives at your hospital's emergency department (ED) feeling miserable, complaining of a severe occipital headache, nausea and vomiting, and blurred vision his skin also appears flushed. ![]()
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