Hypertensive Krise und posteriores reversibles Enzephalopathie-Syndrom (PRES)

2018 ◽  
Vol 86 (05) ◽  
pp. 290-300 ◽  
Author(s):  
Olaf Eberhardt
Keyword(s):  
Hypertensive Emergency ◽  
Hypertensive Urgency ◽  
Hypertensive Krise ◽  
Hypertensiver Notfall

ZusammenfassungDie therapeutische Dringlichkeit der hypertensiven Entgleisung wird vorrangig vom Vorliegen von akuten neurologischen, okulären, kardiopulmonalen oder renalen Endorganschäden bestimmt. Ohne akute Endorganschäden (hypertensive urgency) ist in der Regel eine orale Behandlung mit dem Ziel der RR-Normalisierung über 24–48 h ausreichend. Bei gravierenden hypertensiven Organsymptomen (hypertensive emergency, hypertensiver Notfall) ist eine zügige intravenöse Initialtherapie erforderlich, bei der die Präparatewahl und das Blutdruckziel von der Organmanifestation und Begleiterkrankungen abhängig sind. Empfehlungen zur optimalen Blutdrucksteuerung bei akuten neurovaskulären Erkrankungen werden durch divergierende Studienergebnisse und die Vielfalt potentiell relevanter Parameter erschwert. Das breite Spektrum des posterioren reversiblen Enzephalopathie-Syndroms kann in atypischen Fällen die Diagnose erschweren. Clevidipin könnte in Zukunft eine willkommene Erweiterung der intravenösen Therapieoptionen auch für neurologische Patienten darstellen.

Abstract T3: Type 2 Myocardial Infarction Predicts Outcome In Hypertensive Crisis Patients: Nationwide Analysis

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Ahmed M Maraey ◽  
Ahmed Elzanaty ◽  
Hadeer R Elsharnoby ◽  
Mahmoud Salem ◽  
Mahmoud Khalil ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Hypertensive Crisis ◽  
Primary Diagnosis ◽  
Hypertensive Emergency ◽  
Secondary Outcome ◽  
Hypertensive Urgency ◽  
Emergency Presentation ◽  
The Impact

Background: Type 2 Myocardial infarction (T2MI) can occur in hypertensive crisis patients. The impact of T2MI in this population is poorly understood due to limited available data. Objective: To assess the impact of T2MI on patients admitted to the hospital with hypertensive crisis. Methods: We queried National Readmission Database (NRD) of year 2018 for adult patients admitted with a primary diagnosis of hypertensive crisis. Patients were excluded if they had type 1 myocardial infarction (T1MI), septic shock, or bleeding in the index admission. Primary outcome was 90-day readmission due to T1MI. Secondary outcome was in-hospital mortality. Subgroup analysis was done according to urgency and emergency presentation. Multivariate regression was done to account for confounders. Results: A total of 101211 patients were included in our cohort of whom 3644 (3.6%) were diagnosed with T2MI and 24471 (24.2%) were readmitted within 90 days of discharge. Of those, 912 (3.7%) were diagnosed with T1MI on readmission. T2MI was independently associated with increased odds of 90-day readmission with T1MI (Adjusted odds ratio (aOR): 2.67, 95% CI [1.91-3.75], P=0.000). T2MI effect was observed in hypertensive urgency, and in hypertensive emergency. T2MI was associated with increased in-hospital mortality in hypertensive urgency population (aOR: 4.21, 95% [1.58-11.25], P=0.004) but not in hypertensive emergency (table 1). Conclusion: In hypertensive crisis patients, T2MI was associated with increased 90-day readmission with T1MI. Aggressive management of cardiovascular risk factors and risk stratification should be considered at the time of diagnosis.

scholarly journals Clinical study of hypertensive crisis at a tertiary care hospital of South India

2018 ◽  
Vol 5 (5) ◽  
pp. 1168
Author(s):  
M. Sai Varun ◽  
Usham Gangaram ◽  
M. V. Nagabushana ◽  
H. G. Revana Siddappa ◽  
Bhimasen Soren
Keyword(s):  
Blood Pressure ◽  
Hypertensive Crisis ◽  
Hypertensive Emergency ◽  
Common Symptom ◽  
Sudden Increase ◽  
Care Hospital ◽  
Hypertensive Urgency ◽  
Adequate Treatment ◽  
Arterial Blood ◽  
Study Results

Background: Hypertensive crisis is a severe clinical condition in which sudden increase in arterial blood pressure can lead to acute vascular damage of vital organs. So timely detection, evaluation and adequate treatment are crucial to prevent permanent damage to vital organs. The aim of the present study is to evaluate incidence and clinical presentation of hypertensive crisis in relation to age, sex, severity of hypertension, accompanying symptoms and clinical manifestations.Methods: It is a clinical prospective study done during the period between January to June 2018 at Narayana Medical College, Nellore. All patients who were more than 18 years with blood pressure>180/120 mmHg to the emergency, outpatients, and inpatients were included. A thorough History and clinical examination was done and necessary investigation was sent to the laboratory.Results: The study results indicate that males (64%) were significantly over represented compared to females (36%). Out of 50 patients majority of the subjects belonged to age group of 50-59 years. Out of 50 Patients most common symptom is Headache (48%), Vomiting (48%), Giddiness (38%), Dyspnoea (22%), Loss of consciousness (22%) followed by chest pain (20%), Blurring of vision (20%) and weakness of limbs (14%). Most of the individuals are in the hypertensive emergency (66%) followed by Hypertensive urgency (34%). Out of 50 patients 56% had neurological involvement and 44% had cardiological involvement. Our study states that most of cases were in grade 1retinopathy (8%) followed in order by grade 4 retinopathy (8%), grade 2 retinopathy (6%) and grade 3 retinopathy (6%).Conclusions: The present study concludes that majority of patients present presenting in hypertensive emergency belonged to fifth and sixth decades of age. So, treating physician should rapidly assess the differentiation of hypertensive emergency and hypertensive urgency in order to prevent end organ damage and to prevent further morbidity and mortality.

scholarly journals Clinical profile of patients with hypertensive crisis in a tertiary care hospital in Haryana, India – A retrospective cross-sectional study

2022 ◽  
Vol 13 (1) ◽  
pp. 66-72
Author(s):  
Navtej Singh ◽  
Tarun ◽  
Ravinder Pal ◽  
Ankit Chamoli
Keyword(s):  
Clinical Presentation ◽  
Target Organ Damage ◽  
Tertiary Care ◽  
Hypertensive Crisis ◽  
Organ Damage ◽  
Hypertensive Emergency ◽  
Time Interval ◽  
Care Hospital ◽  
Hypertensive Urgency ◽  
Cross Sectional

Background: A hypertensive crisis may manifest as hypertensive emergency or urgency. Hypertensive emergency is characterized by target organ damage and poses immediate threat to life, a situation not seen in urgency. Aims and Objectives: The aims of the study were as follows: (1) To determine the prevalence of hypertensive crisis classified as emergency, urgency, and pseudocrisis. (2) To assess the various systems (neurological, cardiovascular, and renal) affected in relation to a particular type of hypertensive crisis. Materials and Methods: The retrospective study comprised analysis of medical records of 100 patients of hypertensive crisis admitted to emergency unit of BPS Government Medical College and Hospital for Women, Sonepat, Haryana, India, in the 2 years period from January 2018 to December 2019 and study their prevalence among hospital emergencies and clinical presentation. Results: Total number of clinical emergencies analyzed during this time interval was 6666. The prevalence of hypertensive crisis accounted to 1.5% of all the clinical emergencies received. About 66% presented as hypertensive emergencies, 32% as hypertensive urgency, and 2% presented as hypertensive pseudocrisis. Males of the fifth decade of life while females of the sixth decade of life were most affected by hypertensive crisis. Headache (58%) followed by giddiness (44%) was the most common clinical presentation in the emergency. About 34% of patients had associated neurological deficit. Only 16% of patients had cardiovascular system involvement. Conclusion: Symptoms provided by patients in the emergency department are of paramount importance for the outcome of hypertensive crisis. Severe complication of hypertensive crisis can be prevented if hypertension is timely diagnosed and appropriately managed.

Der hypertensive Notfall

2017 ◽  
Vol 142 (19) ◽  
pp. 1437-1445
Author(s):  
Gerd Bönner
Keyword(s):  
Blood Pressure ◽  
Organ Damage ◽  
Hypertensive Emergency ◽  
Organ Involvement ◽  
Hypertensive Urgency ◽  
Induced Hypotension ◽  
Rapid Action ◽  
Life Threatening ◽  
Acute Increase

AbstractHypertensive urgency and hypertensive emergency are associated with sudden, massive rise in blood pressure. An acute increase in blood pressure to values above 180/120 mmHg is considered critical. If not treated in time, it can quickly enter a life-threatening hypertensive emergency. The symptoms or organ damage determine the assessment as a crisis or an emergency. Rapid action is required. The therapy depends on the severity and the organ involvement. However the general principal is to avoid therapeutically induced hypotension.

scholarly journals Hypertension and emergency medicine: an update

2013 ◽  
pp. 6-13
Author(s):  
Michele Meschi ◽  
Simona Detrenis ◽  
Laura Bianchi ◽  
Marcella Saccò ◽  
Marcello Bertorelli ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Emergency Departments ◽  
Search Strategy ◽  
Pediatric Patients ◽  
Hypertensive Emergency ◽  
Clinical Parameters ◽  
Hypertensive Urgency ◽  
Italian Language ◽  
Hypertensive Crises ◽  
The Individual

The objective of this paper is to evaluate the correct management of hypertension in emergency departments. Studies were identified searching PubMed up to April 30, 2012, combining the terms ‘HYPERTENSIVE EMERGENCY’ and ‘HYPERTENSIVE URGENCY’. The search strategy was limited to English and Italian language papers on adult and pediatric patients. Hypertensive crises are commonly found in emergency departments. A range of pharmacological options are available in this setting, but each physician should tailor theoretical principles to the individual patient according to his or her clinical parameters.

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