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"Hypertensive emergency"

Y Zamami, Y Kouno, T Niimura, M Chuma, T Imai, M Mitsui, T Koyama, M Kayano, N Okada, H Hamano, M Goda, M Imanishi, K Takechi, Y Horinouchi, Y Kondo, H Yanagawa, Y Kitamura, T Sendo, Y Ujike, K Ishizawa
A history of hypertension is a known risk factor for delirium in patients in intensive care units, but the effect of antihypertensive agents on delirium development is unclear. Nicardipine, a calcium channel blocker, is widely used in ICU as a treatment agent for hypertensive emergency. This study investigated the relationship between the administration of nicardipine hydrochloride and delirium development in patients under mechanical ventilation. We conducted a medical chart review of 103 patients, who were divided into two groups according to the use of nicardipine hydrochloride...
December 1, 2018: Die Pharmazie
Bernhard K Krämer, Robert M Krämer, Urs Benck, Bernd Krüger
No abstract text is available yet for this article.
December 5, 2018: Journal of Clinical Hypertension
Naomi Overgaauw, Jelmer Alsma, Anniek Brink, Edon Hameli, Soma Bahmany, Laura E J Peeters, Anton H Van Den Meiracker, Stephanie C E Schuit, Birgit C P Koch, Jorie Versmissen
OBJECTIVES: Over 70% of patients who visit the emergency department with a hypertensive emergency or a hypertensive urgency have previously been diagnosed with hypertension. Drug nonadherence is assumed to play an important role in development of hypertensive urgency and hypertensive emergency, but exact numbers are lacking. We aimed to retrospectively compare characteristics of patients with hypertensive urgency and hypertensive emergency and to prospectively quantify the attribution of drug nonadherence...
November 23, 2018: Journal of Hypertension
Samar Genedy, Ahmed Khames, Amal Hussein, Hatem Sarhan
Background: Hypertensive disorders are the most common complication in pregnancy which can even lead to maternal mortality. Hydralazine hydrochloride (HHC), a direct-acting vasodilator, is intravenously used as the first-line therapy in controlling hypertension in pregnancy (preeclampsia). It suffers poor oral bioavailability (26%-50%) due to first-pass metabolism. Objective: This work aims for the preparation of HHC rapidly disintegrating sublingual tablets of higher absorption rate, short onset of action, and higher bioavailability for rapid control on blood pressure (BP) in hypertensive emergencies especially preeclampsia...
2018: Drug Design, Development and Therapy
Pavitra Kotini-Shah, Susana Cuadros, Felix Huang, Joseph S Colla
Hypertensive emergency is a life-threatening state. End-organ damage affecting the heart accounts for up to 52% of hypertensive emergencies commonly encountered in the emergency department. Recent evidence indicates that strain echocardiography with computerized speckle-tracking is more sensitive at identifying hypertension induced changes in the left ventricle (LV) mechanical function than traditional 2-D echocardiography. We present a case demonstrating the use of emergency physician performed point-of-care strain echocardiography to identify and quantify LV mechanical dysfunction during a hypertensive crisis and to monitor improvement over 6 h...
November 19, 2018: Critical Ultrasound Journal
Chinedum O Ojinnaka, Colleen Heflin
The Supplemental Nutrition Assistance Program (SNAP) is a public policy program that aims to reduce food insecurity-a social determinant of health that has been associated with suboptimal blood pressure control in the United States. The aim of the article was to explore the association between SNAP benefit timing and size and probability of hypertension-related emergency department (ED) claims. This study used the SNAP data from the Missouri's Department of Social Services for January 2010 to December 2013 linked to Medicaid ED claims data...
October 12, 2018: Journal of the American Society of Hypertension: JASH
Nuria Garcia-Fernandez, Javier Beaumont, María U Moreno, Gorka San José, Arantxa González, Javier Díez
No abstract text is available yet for this article.
November 8, 2018: Cardiovascular Research
Robin Hohsfield, Christine Archer-Chicko, Traci Housten, Stephanie Harris Nolley
Pulmonary hypertension (PH) complicates common diseases and can lead to worsening symptoms and increased mortality. A specific group of PH, pulmonary arterial hypertension (PAH), World Health Organization Group 1, may present to the emergency department (ED). We review common ED presentations of patients with PAH such as cardiac arrest/sudden death, right ventricular failure, syncope, hypoxemic respiratory failure, arrhythmias, hemoptysis, pulmonary embolism, chest pain/left main compression syndrome, infection, and considerations for PAH medication administration...
October 2018: Advanced Emergency Nursing Journal
Nicholas Nacca, Rachel Schult, Robert Loflin, Adam Weltler, Rachel Gorodetsky, Sherri Kacinko, Jeffery Moran, Alex Krotulski, Timothy Wiegand
BACKGROUND: Synthetic cannabinoid intoxication has become difficult to diagnose and manage in the United States, in part due to varying clinical effects within this heterogeneous group of compounds. CASE REPORT: A 38-year-old man was admitted with altered mental status and bradycardia. He demonstrated progressive encephalopathy, seizure activity, second-degree atrioventricular block type I, respiratory failure, hypotension, hypothermia, and hypoglycemia. A computed tomography scan of the abdomen and pelvis revealed multiple packages in the patient's stomach and rectum...
October 5, 2018: Journal of Emergency Medicine
Sophie Kuntz, Romain Boulestreau, Sébastien Rubin, Antoine Cremer, Philippe Gosse
Hypertensive emergency. Stable incidence for several decades or even increasing (under diagnosed). Early and specific management improves prognosis. Absence of eye damage or lack of access to fundus should not delay or prevent the diagnosis. Multi Organ Damage Hypertension: new definition for an old entity: unusual, sudden and persistent blood pressure rise without threshold and ocular involvement or involvement of at least 3 target organs among brain, heart, kidney or endothelial disease.
September 2018: La Presse Médicale
Irina Benenson, Frederick Andrew Waldron, Shelly A Jones Dillon, Shreni N Zinzuwadia, Nkehci Mbadugha, Natali Vicente, Ela Aris, Adedamola M Adeboye, Christine Makdisi
AIM: The aim of this study was to identify risk factors for hypertensive emergencies in diabetic patients presenting with severely elevated blood pressure. METHODS: Using electronic medical records, this study identified diabetic patients with hypertensive crisis who presented to the emergency department of Newark Beth Israel Medical Center, Newark, NJ from June 2013 to May 2016. Diabetic patients with hypertensive emergencies were compared with non-diabetic patients based on important demographic and clinical characteristics...
October 4, 2018: Clinical and Experimental Hypertension: CHE
Michael H Chiu, Nakul C Sharma
Thyroid hormones and the cardiovascular system are strongly intertwined with known risk of coronary disease, atrial fibrillation, and cardiomyopathy. Pericardial effusions are commonly seen in cases of severe hypothyroidism, however large to massive pericardial effusions with cardiac tamponade are exceptionally rare. We report a case of a patient presenting with hypertensive emergency and a concomitant diagnosis of primary hypothyroidism with a large pericardial effusion and early echocardiographic features of tamponade...
July 2018: Journal of Cardiology Cases
Tomáš Seeman, Gilad Hamdani, Mark Mitsnefes
Hypertensive crisis is a relatively rare condition in children. However, if not treated, it might be life-threatening and lead to irreversible damage of vital organs. Clinical presentation of patients with hypertensive crisis can vary from very mild (hypertensive urgency) to severe symptoms (hypertensive emergency) despite similarly high blood pressure (BP). Individualized assessment of patients presenting with high BP with emphasis on the evaluation of end-organ damage rather than on the specific BP number is a key in guiding physician's initial management of a hypertensive crisis...
October 1, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
D Sánchez-Fabra, R Marinas Sanz, E Tarí Ferrer, A Gracia Gutiérrez, S López Garrido, M Morando Pérez, B Amores Arriaga, J Cebollada Del Hoyo
OBJECTIVES: To describe the characteristics of hypertensive urgencies at the emergency department, as well as the variables associated with early re-admission (<7 days) and re-admission at one month (<30 days). METHODS: We conducted a descriptive, retrospective study of all patients who were admitted to the emergency department of a third level hospital during 2013. Subsequently, a case-control analysis was performed to analyze the group of patients with readmission...
September 20, 2018: Hipertensión y Riesgo Vascular
Danial Mir, Arash Ardabilygazir, Sonia Afshariyamchlou, Issac Sachmechi
Malignant hypertension (MH) has been described in association with high-dose (50 - 100 mcg) estrogen oral contraceptive pills (OCPs). Although the rise in blood pressure (BP) is usually mild, some women will have a more significant increase in BP, and hypertensive emergencies may very rarely occur. We present a 21-year-old Caucasian female with a past medical history of fibromyalgia and family history of hypertension (both grandparents) who was admitted with a three-day history of headache and blurring of vision in her left eye with a BP of 210/150...
July 13, 2018: Curēus
Jared W Davis, Muhannad Almubarak, Amrita Mukherjee, Samuel K McElwee, Massoud A Leesar, Arka Chatterjee
BACKGROUND: Patients presenting with hypertensive urgency / emergency (HUE) often have systolic heart failure(SHF). Coronary angiography is routinely done for these patients to rule out obstructive coronary artery disease (Obs-CAD). We performed a retrospective study to investigate predictors of ObsCAD in this population. METHODS: Patients who underwent angiography to investigate SHF and had hospital admission(s) for HUE in the preceding 6 months were included in the study...
August 16, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Joseph B Miller, Sean Calo, Brian Reed, Richard Thompson, Bashar Nahab, Evan Wu, Kaleem Chaudhry, Phillip Levy
STUDY OBJECTIVE: In the Emergency Department (ED) setting, clinicians commonly treat severely elevated blood pressure (BP) despite the absence of evidence supporting this practice. We sought to determine if this rapid reduction of severely elevated BP in the ED has negative cerebrovascular effects. METHODS: This was a prospective quasi-experimental study occurring in an academic emergency department. The study was inclusive of patients with a systolic BP (SBP) > 180 mm Hg for whom the treating clinicians ordered intensive BP lowering with intravenous or short-acting oral agents...
August 21, 2018: American Journal of Emergency Medicine
Fabian Rengier, Claudius Melzig, Thorsten Derlin, Alberto M Marra, Jens Vogel-Claussen
Pulmonary hypertension (PH) is a pathophysiological disorder defined by an increase in pulmonary arterial pressure which can occur in multiple clinical conditions. Irrespective of etiology, PH entails a negative impact on exercise capacity and quality of life, and is associated with high mortality particularly in pulmonary arterial hypertension. Noninvasive imaging techniques play an important role in suggesting the presence of PH, providing noninvasive pulmonary pressure measurements, classifying the group of PH, identifying a possibly underlying disease, providing prognostic information and assessing response to treatment...
August 30, 2018: International Journal of Cardiovascular Imaging
Bert-Jan H van den Born, Gregory Y H Lip, Jana Brguljan-Hitij, Antoine Cremer, Julian Segura, Enrique Morales, Felix Mahfoud, Fouad Amraoui, Alexandre Persu, Thomas Kahan, Enrico Agabiti Rosei, Giovanni de Simone, Philippe Gosse, Bryan Williams
Hypertensive emergencies are those situations where very high blood pressure (BP) values are associated with acute organ damage, and therefore, require immediate, but careful, BP reduction. The type of acute organ damage is the principal determinant of: (i) the drug of choice, (ii) the target BP, and (iii) the timeframe in which BP should be lowered. Key target organs are the heart, retina, brain, kidneys, and large arteries. Patients who lack acute hypertension-mediated end organ damage do not have a hypertensive emergency and can usually be treated with oral BP-lowering agents and usually discharged after a brief period of observation...
August 25, 2018: European Heart Journal. Cardiovascular Pharmacotherapy
Patrick Lavin, Morgan Patrylo, Matthew Hollar, Kiersten B Espaillat, Howard Kirshner, Matthew Schrag
PURPOSE: Central retinal artery occlusion (CRAO) is mechanistically similar to a stroke. Current guidelines recommend a standardized and systematic evaluation of risk factors for patients who have had a stroke. This study evaluates the yield of this evaluation in patients with CRAO and frequency of stroke in this population. DESIGN: Cohort study. METHODS: We evaluated the diagnostic yield of an expedited inpatient evaluation of cerebrovascular risk factors in a cohort of patients presenting with an acute CRAO within the period from 2009-2017 at an academic hospital...
August 25, 2018: American Journal of Ophthalmology
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