Hypertensive crisis (طواريء ارتفاع ضغط الدم) - Emergency medicine (Arabic)

Hypertensive crisis (طواريء ارتفاع ضغط الدم) • Preferred terminology Hypertensive crisis (acute severe hypertension): systolic blood pressure ≥ 180 mm Hg and/or diastolic blood pressure ≥ 120 mm Hg Hypertensive urgency: hypertensive crisis that is either asymptomatic or associated with isolated nonspecific symptoms (e.g., headache, dizziness, or epistaxis) without signs of acute organ damage. Hypertensive emergency: hypertensive crisis with signs of acute end-organ damage, mainly in the cardiovascular, central nervous, and renal systems. • Main cause? Non-adherence to antihypertensive drugs • Note Suspect hypertensive encephalopathy in a patient presenting with diffuse neurological symptoms, severe hypertension, and nonspecific or normal neuroimaging. • Management Confirm blood pressure manually and on bilateral upper extremities. Determine if there are signs of acute end-organ damage. Focused history/physical to identify clinical features of hypertensive emergencies Targeted diagnostics for hypertensive crisis Evaluate and treat underlying disorders. Case: A 55-year-old man is brought in to the emergency department (ED) by his wife for altered mental status (AMS). She states that for the past day, he has been confused and unsteady when he walks. The patient has a history of hypertension (HTN) and hyperlipidemia. He complains of headache and blurry vision. On examination, he is alert and oriented to person only. On fundoscopy, the optic discs appear hyperemic and swollen. His neurologic examination is nonfocal and otherwise has a normal physical examination. The patient’s vital signs are a blood pressure of 245/140 mm Hg, heart rate of 95 beats per minute, respiratory rate of 18 breaths per minute, oxygen saturation of 98% on room air and he is afebrile. What is the most likely diagnosis? What is the best management? #hypertension #emergency #طب ========================================================= Youtube:    / drquenawy   Facebook:   / drquenawyfb   Tiktok:   / drquenawy   Instagram:   / drquenawy   Telegram: t.me/DrQuenawy ========================================================= للاستفسار عن أي شيء يرجى التواصل عن طريق إحدى طرق التواصل الاجتماعي الخاصة بي، أو التعليق أسفل الفيديو Dr. Mohamed Quenawy