Mghaieth Fathia

Rabta hospital Tunis, Tunisia

Title: Hypertensive emergencies, nuanced diagnosis and management are needed

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Biography

Fathia Mghaieth Zghal is the coordinator of Cardioreanimation service Echo Lab, Rabta Teaching hospital of Tunis, Tunisia her focus interests are myocardial strain, echo in the ICU , echo in Cath lab, She id also Coordinator of the Acute cardiovascular working group in the Tunisian Society of Carrdiology and cardiovascular surgery concerning academic roles, she is head of department of medicine in the faculty of medicine of Tunis, Tunisia. and the coordinator of acute cardiovascular medicine master in the faculty. Member ot ethics committee in Rabta hospital and coordinator of ethic working group of the publications help commitee. in the faculty of medicine of Tunis, Tunia Member of the tunisian laboratory research "medical biochemistry and genetic of atherosclerosis".

Abstract

Hypertensive emergencies have a large spectrum of clinical manifestations, they involve high acute elevation of blood pressure above 180/110 MmHg and acute one or several visceral damages. Different therapeutic strategies in different environments are needed to control blood pressure, monitor vital parameters, and deliver specific therapies when needed.

 First, they must be distinguished from hypertensive crisis. If confirmed a medical transport to an intensive care unit is needed but the transport has to be oriented in case of aortic dissection, coronary acute syndrome or stroke to respectively cardiovascular surgical, catheter laboratory or stroke departments, as specific treatments are not to be delayed by non-specific blood pressure lowering measures. The medicines as well as the intensity and rapidity of lowering blood pressure itself differ from rapid intense intervention to less than 120/70 MmHg in the first hour in case or aortic dissection to a very careful and progressive lowering to preserve cerebral perfusion in case of stroke. Oral therapies specially angiotensin conversion enzyme inhibitors had encouraging results in recent trials on malignant hypertension. The urgent management is not completed only by detecting and correcting acute elevation of blood pressure and its acute visceral damages. There is a need to detect and treat the aetiology of this serious complication, and to reconnect the patient to a regular management and close following by a specialist in order to prevent relapse of this vital situation.

Finally, registers are needed to detect these complication, epidemiologic data are not well established in this field.