醫學筆記匯整 ED Notes

http://charliekuo.com/?p=4979 

ABC 先顧
先暫且不管造成高血壓危象原因
假如已經出現併發症例如大片ICH造成呼吸無法維持
應該先建立airway

- Hypertensive emergency :
  SBP > 180 and/or DBP > 120 + end-organ damage

- Hypertensive urgency :
  SBP > 180 and/or DBP > 120

- End-organ damage
   Hypertensive encephalopathy
   Stroke
​​​​​​​   Retinal hemorrhage
​​​​​​​   Dissecting aortic aneurysm
​​​​​​​   Acute LV failure with pulmonary edema
​​​​​​​   Acute myocardial ischemia
​​​​​​​   Eclampsia
​​​​​​​   Acute renal failure
​​​​​​​   Symptomatic microangiopathic hemolytic anemia

- Hypertensive emergency with aortic dissection : 
  SBP<120 mmHg within an hour (within 10 min)
- Hypertensive emergency with eclampsia or pheochromocytoma :
  SBP < 140 mmHg within an hour

- Hypertensive emergency, others :
  1hr SBP reduced max 25%
  2-6hr SBP 160/DBP 100-110 mmHg
  24-48hr normal BP

慢性高血壓的病患 autoregulation 已經和一般人不同
過快降低血壓可能造成器官灌流不足

Secondary hypertension 原因

壓力事件造成血壓高