Intern Survival Series: Dyspnea and Hypertension in hospitalized patients Aug 17, 2011 Dan Waldman
Feb 24, 2016
Intern Survival Series: Dyspnea and Hypertension in hospitalized patients
Aug 17, 2011Dan Waldman
Dyspnea: Main Goals Organized thought Process
“Dyspnea” vs “Hypoxia”
“Anchor Bias” in dyspnea
Thoughts on PE
Case Presentation “Mr. Smith’s oxygen requirement is
going up. Now he’s on a facemask.”
On your signout list: “72 yo M with CHF exacerbation and COPD exacerbation…”
Hypertension Urgency/Emergency/”Malignant”
Causes of hypertension in hospitalized pts
Who needs meds? What meds?
Most common presnetations of hypertensive Emergency
Stroke: 25% Pulmonary Edema: 23% Hypertensive Encephalopathy: 16.3% CHF: 12% Some others:
• Intracranial hemorrhage• Aortic dissection• Ecclampsia• MI
Contributing factors Pain Alcohol/benzo withdrawal Cocaine/amphetamines Anxiety BP Med withdrawal White Coat Htn NSAIDs Steroids OSA Cuff Size Urinary Retention (think about in post-op)
This may even be overly aggressive
Some non IV meds (if you must) Nitropaste (can be removed) Captopril Nifedipine Clonidine PO (rebound htn)
But really…do they need these?
Questions?