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Emergency Medicine: Cardiology 213

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  1. Acute Coronary Syndromes: A Focus on STEMI
    10 Topics
    3 Quizzes
  2. Acute decompensated heart failure
    10 Topics
    3 Quizzes
  3. Hypertensive Urgency and Emergency Management
    11 Topics
    3 Quizzes
  4. Acute aortic dissection
    9 Topics
    2 Quizzes
  5. Arrhythmias (Afib, SVT, VTach)
    10 Topics
    2 Quizzes

Participants 206

  • April
  • Alyssa
  • Ashley
  • Amber
  • Sherif
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  • Diagnosis requires meeting 3 criteria:
    • BP > 180/120 mm Hg (lower thresholds may apply in certain populations)
    • Acute end-organ dysfunction
    • Directly attributable to high BP
  • Key initial diagnostic steps:
    • Assess vitals, including duplicate BP checks
    • Full history and physical exam
    • Identify symptoms or signs of end-organ involvement
  • Evaluate for secondary causes:
    • History of prescription, OTC medication use, substance use
    • Dietary changes
    • Symptoms suggesting pheochromocytoma
  • Assess for target organ dysfunction:
    • Neurological exam and imaging (stroke, encephalopathy)
    • Funduscopy (retinopathy, papilledema)
    • Troponin, ECG (MI, heart failure)
    • Creatinine, urinalysis (kidney injury)
    • CT chest (aortic dissection, pulmonary edema)
  • Additional workup guided by organ involved:
    • Stroke evaluation (e.g. brain imaging, vascular studies)
    • ADHF evaluation (e.g. BNP, echocardiogram)
    • AKI evaluation (e.g. electrolytes, renal ultrasound)
  • Make presumptive diagnosis based on BP, acute symptoms, and initial workup
  • Confirm with response to antihypertensive therapy

In summary, the diagnosis of a hypertensive emergency relies on recognizing a severely elevated BP with signs and symptoms of acute end-organ dysfunction that can be attributed to the BP elevation. Pharmacists can assist by identifying secondary causes, guiding the diagnostic workup based on potential end-organ involvement, and assessing the response to treatment.