Zaporozhye State Medical University
Lecturer: Mirniy Sergey Petrovich, assistant, candidate of medical sciences
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Hypertensive сrisis презентация
Содержание
- 1. Hypertensive сrisis
- 2. Topic: Hypertensive Crisis A hypertensive crisis (HC)
- 3. Signs and symptoms of HC may include:
- 4. Life–threatening signs and symptoms of HC:
- 5. TREATMENT Initial Treatment of Hypertensive Emergency:
- 6. Parenteral Agents for Hypertensive Emergencies: Labetalol
- 7. SYNCOPE Syncope is defined as a transient
- 8. Causes Cardiac causes: Abnormal heart rhythms Bradycardia
- 9. Laboratory Studies Serum glucose level CBC
- 10. Imaging Studies CHEST RADIOGRAPHY HEAD CT-SCANNING
- 11. Situational syncope treatment focuses on educating
- 12. Cardiac arrhythmia Cardiac arrhythmia is a term
- 13. Arrhythmia Types Sinus arrhythmia Sinus tachycardia Sick
- 14. Symptoms Palpitations: increased awareness of the heart
- 15. Tests for detecting Arrhythmias Electrocardiogram
- 16. Antiarrhythmic Classification Class 1a. Quinidine, Procainamide,
- 17. Special Treatment Cardioversion. Doctor may apply
Topic: Hypertensive Crisis A hypertensive crisis (HC) is a severe increase in blood pressure that can lead to a stroke. Extremely high blood pressure – above 180/ /110 mm of mercury
Слайд 1Chair of Medicine of Catastrophes,
Neurosurgery and Military Medicine
Lecture: Critical Care on
Cardiovascular Diseases
Слайд 2Topic: Hypertensive Crisis
A hypertensive crisis (HC) is a severe increase in
blood pressure that can lead to a stroke.
Extremely high blood pressure – above 180/ /110 mm of mercury (mm Hg) – damages blood vessels.
HC is divided into 2 categories – urgent and emergency.
Extremely high blood pressure – above 180/ /110 mm of mercury (mm Hg) – damages blood vessels.
HC is divided into 2 categories – urgent and emergency.
Слайд 3Signs and symptoms of HC
may include:
Elevated blood pressure
Severe headache
Severe anxiety
SHORTNESS
OF BREATH
Слайд 4Life–threatening signs and symptoms of HC:
Fluid in lungs (pulmonary edema)
Brain swelling or bleeding
A tear in aorta (aortic dissection)
Heart attack
Stroke
Eclampsia (on pregnant)
Слайд 5TREATMENT
Initial Treatment of Hypertensive Emergency:
The initial goal for BP reduction
to achieve a progressive, controlled reduction in BP to minimise to risk of hypoperfusion in cerebral, coronary and renovascular beds.
Oral agents for Severe Hypertension
Captopril (enalapril, ramipril) – ACE-inhibitor
Oral agents for Severe Hypertension
Captopril (enalapril, ramipril) – ACE-inhibitor
Clonidine – centrally acting alpha-adrenergic agonist
Labetalol – a combined alpha- and beta- adrenergic-blocking agent
Prazosin – an alpha-adrenergic blocking agent
Слайд 6Parenteral Agents for Hypertensive Emergencies:
Labetalol
Sodium nitroprusside
Nicardipine
Nitroglycerine
Fenoldopam
Hydralasine
Enalaprilat
Esmolol
Phentolamine
Diazoxide
Слайд 7SYNCOPE
Syncope is defined as a transient
self-limited loss of consciousness
with
an inability to maintain postural
tone that is followed by spontaneous
recovery.
The term syncope excludes seizures,
coma, shock or other states of altered
consciousness
tone that is followed by spontaneous
recovery.
The term syncope excludes seizures,
coma, shock or other states of altered
consciousness
Слайд 8Causes
Cardiac causes:
Abnormal heart rhythms
Bradycardia
Sick-sinus (variable)
Supraventricular or ventricular tachycardia
Cardiac outflow obstruction
Acute myocardial
infarction
Aortic dissection
Cardiomyopathy
Aortic dissection
Cardiomyopathy
Noncardiac causes:
Vasovagal
Dehydratation
Situational syncope Neurologic Syncope
Слайд 9Laboratory Studies
Serum glucose level
CBC (complete blood cell count level)
Serum electrolyte level
Cardiac
enzymes
Urinalysis
Urinalysis
Слайд 10Imaging Studies
CHEST RADIOGRAPHY
HEAD CT-SCANNING
ECHOCARDIOGRAPHY
ELECTROCARDIOGRAPHY
HOLTER MONITOR
STRESS-TEST CARDIAC
HEAD – UP TILT –
TABLE TEST
CAROTID DOPPLER
ELECTROPHYSIOLOGICAL TESTING
CAROTID DOPPLER
ELECTROPHYSIOLOGICAL TESTING
Слайд 11
Situational syncope treatment focuses on educating patients about the condition
Orthostatic syncope
treatment also focuses on educating the patients
Cardiac arrhythmic syncope is treated with antiarrhythmic drugs or pacemaker placement
Cardiac syncope may be treated with beta-blockade to decrease outflow obstruction
Neurologic syncope may be treated in the same fashion as orthostatic syncope
Cardiac arrhythmic syncope is treated with antiarrhythmic drugs or pacemaker placement
Cardiac syncope may be treated with beta-blockade to decrease outflow obstruction
Neurologic syncope may be treated in the same fashion as orthostatic syncope
Emergency Department Care
Слайд 12Cardiac arrhythmia
Cardiac arrhythmia is a term for any of a large
and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heart beat may be too fast or too slow, and may be regular or irregular.
Слайд 13Arrhythmia Types
Sinus arrhythmia
Sinus tachycardia
Sick synus syndrome
Premature Atrial Contraction ( PAC )
Supraventricular
tachycardia ( SVT )
Wolff-Parkinson-White syndrome ( WPW )
Atrial flutter
Atrial fibrillation
Ventricular tachycardia ( VT )
Ventricular fibrillation
Cardiac Standstyll ( Asystole )
Wolff-Parkinson-White syndrome ( WPW )
Atrial flutter
Atrial fibrillation
Ventricular tachycardia ( VT )
Ventricular fibrillation
Cardiac Standstyll ( Asystole )
Слайд 14Symptoms
Palpitations: increased awareness of the heart beating faster
CHEST PAIN
SHORTNESS OF
BREATH
LIGHTHEADEDNESS OF FAINTING
FATIQUE OR WEAKNESS
LIGHTHEADEDNESS OF FAINTING
FATIQUE OR WEAKNESS
Слайд 15Tests for detecting Arrhythmias
Electrocardiogram ( ECG )
Resting
ECG
Exercise ECG ( stress-test )
24 – Hour ECG ( Holter ) monitoring
Transtelephonic monitoring
Intracardiac Electrophysiologic Procedure
Esophageal Electrophysiologic Procedure
Exercise ECG ( stress-test )
24 – Hour ECG ( Holter ) monitoring
Transtelephonic monitoring
Intracardiac Electrophysiologic Procedure
Esophageal Electrophysiologic Procedure
Слайд 16Antiarrhythmic Classification
Class 1a. Quinidine, Procainamide, Disopyramide. Uses: ventricular A., prevention
of AF
Class 1b. Lidocaine, Phenytoin, Mexiletine.Uses: VA
Class 1c. Flecainide, Propafenone, Moricizine. Uses: prevents paroxysmal AF, treats recurrent tachyarrythmias.
Class 2. Beta-blocking. Propranolol, Timolol, Sotalol, Metoprolol, Atenolol. Uses: Prevent Recurrence of Tacchyarr.
Class 3. K-channel blocker. Amiodarone, Ibutilide. Uses: in WPW-syndrome. Atrial Fibrillation.
Class 4. Ca-channel blocker. Verapamil, Diltiazem. Prevent recurrence of paroxysmal Supraventricular tachyarrythmias.
Class 1b. Lidocaine, Phenytoin, Mexiletine.Uses: VA
Class 1c. Flecainide, Propafenone, Moricizine. Uses: prevents paroxysmal AF, treats recurrent tachyarrythmias.
Class 2. Beta-blocking. Propranolol, Timolol, Sotalol, Metoprolol, Atenolol. Uses: Prevent Recurrence of Tacchyarr.
Class 3. K-channel blocker. Amiodarone, Ibutilide. Uses: in WPW-syndrome. Atrial Fibrillation.
Class 4. Ca-channel blocker. Verapamil, Diltiazem. Prevent recurrence of paroxysmal Supraventricular tachyarrythmias.
Слайд 17Special Treatment
Cardioversion. Doctor may apply an electrical shock to the
chest wall.
Automatic implantable defibrillators. To correct serious ventricular arrhythmias.
Artificial Pacemaker.
Radiofrequency Catheter Ablation and Surgery
Automatic implantable defibrillators. To correct serious ventricular arrhythmias.
Artificial Pacemaker.
Radiofrequency Catheter Ablation and Surgery
