1,074 results match your criteria Hypertensive Emergencies


Anesthesia for Obstetric Disasters.

Adv Anesth 2020 Dec;38:229-250

Department of Anesthesiology, Yale School of Medicine, 333 Cedar Street, PO Box 208051, New Haven, CT 06520-8051, USA.

Over the past 30 years, maternal mortality has increased in the United States to 18 deaths per 100,000 live births. Obstetric emergencies, including hemorrhage, hypertensive disorders in pregnancy, HELLP syndrome, and amniotic fluid embolism, and anesthesia complications, including high neuraxial blockade, local anesthetic systemic toxicity, and the difficult obstetric airway, contribute to maternal cardiac arrest and maternal and fetal morbidity and mortality. Expeditious intervention by the obstetric anesthesiologist is critical in these emergent scenarios, and knowledge of best practices is essential to improve maternal and fetal outcomes. Read More

View Article and Full-Text PDF
December 2020

Safety in Dermatologic Procedures: Hypertensive Crises and Potentially Fatal Arrhythmias.

Actas Dermosifiliogr 2021 Jun 22;112(6):516-519. Epub 2021 Mar 22.

Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, Spain.

As dermatologic surgeons often have to perform long surgeries with local anesthetic only, they should be familiar with the fundamentals of how to manage 2 potentially serious complications: Hypertensive crises and intraoperative arrhythmias. Hypertensive crises can be classified as 1) hypertensive urgencies, characterized by a significant spike in blood pressure (>180/110 mmHg) without target-organ dysfunction or 2) hypertensive emergencies, characterized by a blood pressure above 180/110 mmHg with progressive target-organ damage. In emergencies, the blood pressure needs to be reduced immediately whereas in urgencies the goal is to reduce it over several days. Read More

View Article and Full-Text PDF

COVID-19: Patient care after discharge from the Intensive Care Unit.

Int J Clin Pract 2021 Jun 3:e14270. Epub 2021 Jun 3.

Pneumology Department, Août Hospital, Ibn Rochd University Hospital of Casablanca, Casablanca, Morocco.

Introduction: The Ibn Rochd CHU is a tertiary care structure that provides care for the most severe cases of COVID-19 requiring hospitalization in intensive care. The objective of study is to describe the complementary medical and psychological care of patients with COVID-19 in the endocrinology department after a stay in intensive care.

Patients And Methods: This is a descriptive observational study of patients transferred from the intensive care unit to the endocrinology service following a COVID-19 infection during the period from 17 April 2020 to May 26, 2020. Read More

View Article and Full-Text PDF

Hypertension in the hospitalized patient: An update.

Nefrologia 2021 May 29. Epub 2021 May 29.

Consultant, Department of Medicine, Whakatane Hospital, New Zealand. Electronic address:

In-patient hypertension is a common problem seen in the hospital setting. Current evidence-based guidelines define and address management of hypertension in ambulatory care and hypertensive emergencies in the hospital setting. However, they lack guidance for the management of acute asymptomatic/non-emergent hypertension in the hospitalised patient. Read More

View Article and Full-Text PDF

Review of Referrals Sent to the Emergency Department for Management of Hypertension.

Cardiol Res 2021 Jun 14;12(3):156-160. Epub 2021 May 14.

Department of Family Medicine, University of Ottawa, 713 Montreal Road, Ottawa, ON K1K 0T2, Canda.

Background: Hypertensive urgencies, unlike hypertensive emergencies, are severe episodes of hypertension without evidence of end-organ damage. Most recent guidelines advise against referring patients with hypertensive urgencies to the emergency department (ED) for treatment. There is a lack of Canadian data surrounding whether referrals to the ED regarding hypertension are appropriate. Read More

View Article and Full-Text PDF

Management of hypertensive emergencies: a practical approach.

Blood Press 2021 May 8:1-12. Epub 2021 May 8.

Department of Medicine - Emergencies and Hypertension Unit, University of Padua, Padova, Italy.

Acute increases of high blood pressure values, usually described as 'hypertensive crises', 'hypertensive urgencies' or 'hypertensive emergencies', are common causes of patients' presentation to emergency departments. Owing to the lack of ad hoc randomized clinical trials, current recommendations/suggestions for treatment of these patients are not evidenced-based and, therefore, the management of acute increases of blood pressure values represent a clinical challenge. However, an improved understanding of the underlying pathophysiology has changed radically the approach to management of the patients presenting with these conditions in recent years. Read More

View Article and Full-Text PDF

A woman in her fifties with abdominal pain and severe lactic acidosis.

Tidsskr Nor Laegeforen 2021 05 27;141(7). Epub 2021 Apr 27.

Background: Pheochromocytoma is referred to as 'the great mimic' with a broad spectrum of presenting symptoms. In the following case, the diagnosis had an unusual presentation as a medical emergency - pheochromocytoma crisis.

Case Presentation: A previously healthy woman in her fifties was admitted due to abdominal pain and dyspnoea. Read More

View Article and Full-Text PDF

[Blood pressure measurement campaign (May Measurement Month) from community pharmacies in 2018: analysis of screening in Spain].

Hipertens Riesgo Vasc 2021 Apr 13. Epub 2021 Apr 13.

Instituto de Investigación 12 de octubre, Madrid, España.

Introduction: Within the international project May Measurement Month, in Spain, the community pharmacy is where the greatest number of measurements are carried out and where the population can be made aware of the importance of regular blood pressure measurement.

Objectiv: To ascertain the situation of the Spanish population's blood pressure and dissemination of the importance of its regular measurement through the community pharmacies.

Methods: Cross-sectional descriptive study carried out in Spanish community pharmacies during the month of May 2018, among pharmacy users of legal age. Read More

View Article and Full-Text PDF

Abdominal paraaortic paraganglioma: Management of intraoperative hemodynamic emergencies during elective resection procedures (A case presentation).

Exp Ther Med 2021 May 23;21(5):543. Epub 2021 Mar 23.

Department of Cardiovascular Surgery, 'Prof. Dr. C. C. Iliescu' Institute of Emergency for Cardiovascular Diseases, 022322 Bucharest, Romania.

Paragangliomas are extremely rare neuroendocrine tumors. We report a case of a 44-year-old man with hypertension who presented a tumoral mass located retroperitoneally at the aortic bifurcation which included both the common iliac arteries and the posterior left iliac vein, who experienced an unpredictable intraoperative cardiac arrest with electromechanical dissociation at 5 min after laparotomy. After successful resuscitation and hemodynamic stability, the lesion was fully excised. Read More

View Article and Full-Text PDF

Hypertensive Emergencies in the Ambulance: Characteristics, Clinical Presentations and Complications - A Prospective Cohort Study.

Open Access Emerg Med 2021 26;13:75-81. Epub 2021 Feb 26.

Audit Department, Emergency Medical Services, Ministry of Health, Kuwait, Kuwait.

Background: The objective of this study is to describe the characteristics of hypertensive emergencies in Kuwait aiming to provide a preliminary background to update the current guidelines and improve patients' management.

Methods: This is a prospective analysis of hypertensive emergency cases retrieved from emergency medical services (EMS) archived data between 1 January - 30 June 2020. Collected variables included patient characteristics, clinical presentations, vital signs, interventions, and complications. Read More

View Article and Full-Text PDF
February 2021

Circulating microRNAs May Serve as Biomarkers for Hypertensive Emergency End-Organ Injuries and Address Underlying Pathways in an Animal Model.

Front Cardiovasc Med 2020 12;7:626699. Epub 2021 Feb 12.

Department of Nephrology, Clinic of Medicine, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.

There is an incomplete understanding of the underlying pathophysiology in hypertensive emergencies, where severely elevated blood pressure causes acute end-organ injuries, as opposed to the long-term manifestations of chronic hypertension. Furthermore, current biomarkers are unable to detect early end-organ injuries like hypertensive encephalopathy and renal thrombotic microangiopathy. We hypothesized that circulating microRNAs (c-miRs) could identify acute and chronic complications of severe hypertension, and that combinations of c-miRs could elucidate important pathways involved. Read More

View Article and Full-Text PDF
February 2021

Clinical treatment outcomes of hypertensive emergency patients: Results from the hypertension registry program in Northeastern Thailand.

J Clin Hypertens (Greenwich) 2021 Mar 7;23(3):621-627. Epub 2020 Dec 7.

Accident and Emergency Nursing Division, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.

Hypertensive emergency care is a challenge in clinical practices due to vital organ complications that may lead to unfavorable outcomes if left untreated. The objectives of this study were to determine the prevalence, clinical characters, treatment, and outcomes of hypertensive emergency patients. A retrospective cohort study was conducted at a university hospital in Northeast Thailand from January 2016 to December 2019. Read More

View Article and Full-Text PDF

Update on hypertensive disorders in pregnancy.

BJA Educ 2020 Dec 12;20(12):411-416. Epub 2020 Oct 12.

Poole NHS Foundation Trust, Poole, Dorset, UK.

View Article and Full-Text PDF
December 2020

The UrgeRe (Urgenze Ipertensive: Un Progetto Educazionale Fondato Sulla Vita Reale, Hypertensive Urgencies: A Project in the Real World) Project.

High Blood Press Cardiovasc Prev 2021 Mar 5;28(2):151-157. Epub 2021 Feb 5.

Department of Internal Medicine and Public Health, University of Aquila, L'Aquila, Italy.

The approach to hypertensive emergiencies (HE) and urgencies (HU) may be different according to local clinical practice, despite recent guidelines and position papers recommendations. The Italian Society of Hypertension (Società Italiana della Ipertensione Arteriosa, SIIA) developed an online survey, in order to explore the awareness, management and treatment of HU in Italy, sending by e mail a 12 items questionnaire to the members of the SIIA. The results show that the definition of HU was correctly identified by 62% of the responders. Read More

View Article and Full-Text PDF

Anesthetic challenges while performing emergency laparotomy in a patient having COVID-19 infection.

J Postgrad Med 2021 Jan-Mar;67(1):39-42

Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

An elderly hypertensive lady presented with fever, respiratory symptoms, and mild abdominal discomfort and was diagnosed to have COVID-19 pneumonia. Respiratory symptoms improved with steroids, awake proning, high flow nasal cannula oxygen therapy and antibiotics. After 4 days, she developed non-occlusive superior mesenteric artery thrombosis, which initially responded to anticoagulants but was complicated on tenth day by intestinal obstruction necessitating emergency surgery. Read More

View Article and Full-Text PDF
February 2021

Safety in Dermatologic Procedures: Hypertensive Crises and Potentially Fatal Arrhythmias.

Actas Dermosifiliogr 2021 Jun 27;112(6):516-519. Epub 2021 Jan 27.

Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España.

As dermatologic surgeons often have to perform long surgeries with local anesthetic only, they should be familiar with the fundamentals of how to manage 2 potentially serious complications: Hypertensive crises and intraoperative arrhythmias. Hypertensive crises can be classified as 1) hypertensive urgencies, characterized by a significant spike in blood pressure (>180/110mmHg) without target-organ dysfunction or 2) hypertensive emergencies, characterized by a blood pressure above 180/110mmHg with progressive target-organ damage. In emergencies, the blood pressure needs to be reduced immediately whereas in urgencies the goal is to reduce it over several days. Read More

View Article and Full-Text PDF

Implementation of a referral and expert advice call Center for Maternal and Newborn Care in the resource constrained health system context of the Greater Accra region of Ghana.

BMC Pregnancy Childbirth 2021 Jan 13;21(1):56. Epub 2021 Jan 13.

Ghana Health Service, Greater Accra Regional Health Directorate, Accra, Ghana.

Background: Referral and clinical decision-making support are important for reducing delays in reaching and receiving appropriate and quality care. This paper presents analysis of the use of a pilot referral and decision making support call center for mothers and newborns in the Greater Accra region of Ghana, and challenges encountered in implementing such an intervention.

Methods: We analyzed longitudinal time series data from routine records of the call center over the first 33 months of its operation in Excel. Read More

View Article and Full-Text PDF
January 2021

Patterns and outcomes of admissions to the medical acute care unit of a tertiary teaching hospital in South Africa.

Afr J Emerg Med 2021 Mar 8;11(1):26-30. Epub 2020 Dec 8.

Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.

Background: A Medical Acute Care Unit (MACU) was established at Chris Hani Baragwanath Academic Hospital (CHBAH) to provide comprehensive medical specialist care to the patients presenting with acute medical emergencies. Improved healthcare delivery systems at the MACU may result in shorter hospital stays, better outcomes, and less mortality.

Objectives: The study's objective was to describe the demographics, diagnoses, disease patterns, and outcomes, including patient's mortality, admitted to the MACU at CHBAH. Read More

View Article and Full-Text PDF

Hypertensive Crisis in Pregnancy with COVID19: Confirmed with rt-PCR for Nasopharyngeal Swab.

Case Rep Obstet Gynecol 2020 27;2020:8868952. Epub 2020 Nov 27.

De Soysa Hospital for Women, Colombo 10, Sri Lanka.

The novel coronavirus has already spread across the geographical borders to 213 countries and self-governing territories. However, the effect of SARS-CoV-2 infection on pregnant mothers is still poorly understood and sparsely documented. Here, we present a case of a primi mother, who presented with diarrheal episode and proceeded to a hypertensive crisis and placental abruption with rt-PCR (nasopharyngeal swab) confirmed for COVID19. Read More

View Article and Full-Text PDF
November 2020

Detecting the Uncommon Imaging Manifestations of Posterior Reversible Encephalopathy Syndrome (PRES) in Adults: a Comprehensive Illustrated Guide for the Trainee Radiologist.

Curr Probl Diagn Radiol 2020 Nov 15. Epub 2020 Nov 15.

Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore. Electronic address:

Posterior reversible encephalopathy syndrome (PRES) has traditionally been described as a reversible leukoencephalopathy with a distinct pattern of posteriorly distributed vasogenic oedema involving the subcortical regions of parietal and occipital lobes. PRES commonly occurs in the setting of hypertensive emergencies, pre-eclampsia/eclampsia, impaired renal function, and immunosuppressive therapy. The various clinical presentations of PRES include encephalopathy, seizures, headache, visual, and focal neurological deficits. Read More

View Article and Full-Text PDF
November 2020

Hypertensive Disorders of Pregnancy.

Cardiol Clin 2021 Feb 2;39(1):77-90. Epub 2020 Nov 2.

Department of Medicine, Division of Cardiology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, 622 West 168th Street, PH 3-342, New York, NY 10032, USA. Electronic address:

Hypertension is the most common medical disorder occurring during pregnancy and a leading cause of maternal and perinatal morbidity and mortality. Accurate blood pressure measurement and the diagnosis and treatment of hypertensive disorders during pregnancy and in the postpartum period are pivotal to improve outcomes. This article details hemodynamic adaptations to pregnancy and provides an approach to the prevention, diagnosis, and management of hypertensive disorders of pregnancy (HDP) and hypertensive emergencies. Read More

View Article and Full-Text PDF
February 2021

Emergency Neuropharmacology.

Emerg Med Clin North Am 2021 Feb 5;39(1):133-154. Epub 2020 Nov 5.

Emergency Medicine, Department of Pharmacy, The University of Vermont Medical Center, 111 Colchester Avenue, Mailstop 272 BA1, Burlington, VT 05401, USA. Electronic address: https://twitter.com/RxEmergency.

Management of acute neurologic disorders in the emergency department is multimodal and may require the use of medications to decrease morbidity and mortality secondary to neurologic injury. Clinicians should form an individualized treatment approach with regard to various patient specific factors. This review article focuses on the pharmacotherapy for common neurologic emergencies that present to the emergency department, including traumatic brain injury, central nervous system infections, status epilepticus, hypertensive emergencies, spinal cord injury, and neurogenic shock. Read More

View Article and Full-Text PDF
February 2021

Efficacy of nifedipine versus hydralazine in the management of severe hypertension in pregnancy: A randomised controlled trial.

Niger Postgrad Med J 2020 Oct-Dec;27(4):317-324

Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria.

Background: Despite the availability of effective antihypertensive drugs, the quality of evidence regarding the best antihypertensive agent for the treatment of hypertensive emergencies in pregnancy is still poor.

Aim: The aim of this study was to compare the efficacy and side effects of oral nifedipine and intravenous hydralazine for control of blood pressure (BP) in severe hypertension in pregnancy.

Materials And Methods: An open-label, parallel, randomised, controlled trial of 78 pregnant women (≥28 weeks' gestation) with severe hypertension was conducted. Read More

View Article and Full-Text PDF
January 2021

Transient Global Amnesia in a Patient Presenting with Hypertensive Emergency; a Case Report.

Arch Acad Emerg Med 2020 28;8(1):e66. Epub 2020 Jul 28.

Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Transient global amnesia (TGA) is characterized by the abrupt onset of global amnesia, particularly anterograde amnesia. The pathophysiology of TGA is poorly understood and it could be caused by various factors and be associated with various diseases. We report a 58-year-old man who presented to the local emergency room with TGA lasting for several hours. Read More

View Article and Full-Text PDF

[Ocular ultrasound: A new tool for the management of hypertensive emergencies?]

Hipertens Riesgo Vasc 2021 Jan-Mar;38(1):48-49. Epub 2020 Oct 10.

Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital Virgen Macarena, Universidad de Sevilla, Sevilla, España.

View Article and Full-Text PDF
October 2020

Availability of equipment and medications for non-communicable diseases and injuries at public first-referral level hospitals: a cross-sectional analysis of service provision assessments in eight low-income countries.

BMJ Open 2020 10 10;10(10):e038842. Epub 2020 Oct 10.

Program in Global Noncommunicable Disease and Social Change, Harvard Medical School Department of Global Health and Social Medicine, Boston, Massachusetts, USA

Context And Objectives: Non-communicable diseases and injuries (NCDIs) comprise a large share of mortality and morbidity in low-income countries (LICs), many of which occur earlier in life and with greater severity than in higher income settings. Our objective was to assess availability of essential equipment and medications required for a broad range of acute and chronic NCDI conditions.

Design: Secondary analysis of existing cross-sectional survey data. Read More

View Article and Full-Text PDF
October 2020

Funduscopy: Yes or no? Hypertensive emergencies and retinopathy in the emergency care setting; a retrospective cohort study.

J Clin Hypertens (Greenwich) 2021 Jan 5;23(1):166-171. Epub 2020 Oct 5.

Department of Internal Medicine, Flevohospital, Almere, The Netherlands.

According to international guidelines, patients with a suspected hypertensive emergency (HE) admitted to the emergency department (ED) should undergo comprehensive evaluation including funduscopic examination. However, funduscopy is not always readily available and little is known about the prevalence of retinopathy among these patients in the ED setting. In order to characterize patients who should undergo funduscopy, we studied the prevalence, characteristics and clinical outcome in patients with a suspected HE and retinopathy grade III/IV. Read More

View Article and Full-Text PDF
January 2021

Funduscopy in hypertensive emergencies: Detecting flames in the cotton fields.

J Clin Hypertens (Greenwich) 2021 Jan 3;23(1):172-174. Epub 2020 Oct 3.

Department of Internal and Vascular Medicine, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands.

View Article and Full-Text PDF
January 2021

Hypertensive Emergency in a Woman with Systemic Sclerosis.

High Blood Press Cardiovasc Prev 2020 Dec 1;27(6):597-599. Epub 2020 Oct 1.

Rheumatology and Immunology Department, National Institute of Medical Science and Nutrition "Salvador Zubiran", Mexico City, Mexico.

Systemic sclerosis (SSc) is a rare autoimmune disease that causes fibrosis in the skin and subcutaneous tissue, involving other organs such as the heart, lungs, kidneys, and gastrointestinal tract. Additionally, it can cause pulmonary arterial hypertension. Scleroderma renal crisis (SRC) is one of the most dreadful complications of SSc. Read More

View Article and Full-Text PDF
December 2020

Midwives' knowledge of pre-eclampsia management: A scoping review.

Women Birth 2021 Feb 11;34(1):87-104. Epub 2020 Sep 11.

College of Nursing and Midwifery, Charles Darwin University, Darwin, Australia.

Background: Pre-eclampsia is a multi-organ disease affecting pregnant women from the second trimester onwards resulting in multiple adverse outcomes. Sub-optimal treatment of pre-eclampsia is linked with unfavorable outcomes. It is critical for midwives as primary providers to be competent in the diagnosis and management of pre-eclampsia especially in low-and middle-income countries. Read More

View Article and Full-Text PDF
February 2021