|Table 247-9 Preferred Parenteral Drugs for Selective Hypertensive Emergencies|
|Hypertensive Encephalopathy||Nitroprusside, nicardipine, labetalol|
|Malignant Hypertension||Labetalol, Nicardipine, Nitroprusside, Enalaprilat|
|Stroke||Nicardipine, Labetalol, Nitroprusside|
|Myocardial Infarction||Nitroglycerine, Nicardipine, Labetalol, Esmolol|
|Acute LV failure||Nitroglycerine, Enalaprilat, Loop diuretics|
|Aortic dissection||Nitroprusside, Esmolol, Labetalol|
|Adrenergic crisis||Phentolamine, Nitroprusside|
|Post operative hypertension||Nitroglycerine, Nicardipine, Labetalol, Nitroprusside|
|Pre eclampsia/Eclampsia||Hydralazine, Labetalol, Nicardipine|
Hypertensive heart disease is the result of structural and functional adaptations leading to LVH, CHF, abnormalities of blood flow due to atherosclerotic CAD and microvascular disease, and cardiac arrhythmias.
Mechanisms of kidney-related hypertension include a diminished capacity to excrete sodium, excessive renin secretion in relation to volume status, and sympathetic nervous system overactivity
NCEP/ATP III 2001 Criteria for the Metabolic Syndrome (Table 242-1) 3 or more of the following
Chemotherapeutic agents are the most common drugs implicated in cardiomyopathy.
Patients with severe AR may respond to IV diuretics and vasodilators, but stabilization is usually short-lived and operation is indicated urgently. Intra aortic balloon counterpulsation is contraindicated and beta blockers are also best avoided so as not to reduce the cardiac output further. Surgery is the treatment of choice and is usually necessary within 24hrs of diagnosis.
The most common type of fibromuscular dysplasia is medial hyperplasia.
A positive abdominojugular reflex, elicited with firm and consistent pressure over the right upper quadrant of the abdomen, is defined by a sustained raise of more than 3cm in jugular venous pressure for at least 5seconds after release of the hand.
In patients with tachycardia-bradycardia variant of sisk-sinus syndrome (SSS) who are at greatest risk for thromboembolism, ie., patients > 65 yo, and with a prior history of stroke, VHD, LV dysfunction or atrial enlargement, anticoagulants should be given.