dr. antonio nolasco rodriguez medicina … · chest vol 131 issue 6 , june 2007 si la pas era mayor...
TRANSCRIPT
![Page 1: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/1.jpg)
Company
LOGO
CRISIS HIPERTENSIVAS
DR. ANTONIO NOLASCO RODRIGUEZ
MEDICINA INTERNA
![Page 2: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/2.jpg)
OBJETIVOS
INICIAR EL TRATAMIENTO INMEDIATO 1
PREVENIR Y DISMINUIR EL DAÑOA ORGANO BLANCO2
![Page 3: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/3.jpg)
EPIDEMIOLOGIA
� LA HIPERTENSION AFECTA A MASDE 65 MILLONES DE PERSONAS ENEUA .
� AFECTA AL 30% DE LA POBLACION
Hypertensive Crises Challenges and Management Chest Vol 131 Issue 6 , June 2007
� AFECTA AL 30% DE LA POBLACION MAYOR DE 20 AÑOS
� EL 1 A 2 % ACUDEN A SERVICIO DE URGENCIAS POR ELEVACIONES DE LA PRESION ARTERIAL
![Page 4: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/4.jpg)
DEFINICIONES
2003 JNC 7 CLASIFICACION
BP CLASE SISTOLICA mmHg DIASTOLICA mmHg
Normal < 120 <80
Prehipertensiòn 121 – 139 80 - 89
Edio I 140 - 159 90 – 99Edio I 140 - 159 90 – 99
Edio II > O = 160 > O = 100
Hypertensive Crises Challenges and Management Chest Vol 131 Issue 6 , June 2007
SI LA PAS ERA MAYOR A 179 mmHg O PAD MAYOR A 109 mmHg
CRISIS HIPERTENSIVA
![Page 5: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/5.jpg)
DEFINICIONES
CATEGORIA SISTOLICA DIASTOLICA
Optima < 120 <80
Normal 120 a 129 80 a 84
Normal elevada 130 a139 85 a 89
Hipertensiòn grado 1 140 a159 90 a 99
Hipertensiòn grado 2 160 a 179 100 a 109Hipertensiòn grado 2 160 a 179 100 a 109
Hipertensiòn grado 3 > O = 180 > O = 110
Hipertensiòn sistòlicaaislada
> O = 140 < 90
2007 Guidelines for the management of arterial hypertension , European Heart Journal 2007 , 28 , 1462 - 1536
PAS MAYOR DE 180 mmHg O PAD MAYOR DE 11OmmHg
CRISIS HIPERTENSIVA
![Page 6: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/6.jpg)
DEFINICIONES
1.- HIPERTENSION SEVERA
HAS excede 180 / 110 mmHg enausencia de sìntomas solo cefalealeve o moderada .
2.- URGENCIA HIPERTENSIVA
HAS excede 180 / 110 mmHg enpresencia de sìntomas severos sindaño a òrgano blanco
Prim Care Clin Office Practice 35 ( 2008) 475 - 487
![Page 7: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/7.jpg)
DEFINICIONES
3.- EMERGENCIA HIPERTENSIVA
HAS de > 220/140 mmHg agregàndoseuna disfunciòn de òrgano blanco .
Prim Care Clin Office Practice 35 ( 2008) 475 - 487
![Page 8: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/8.jpg)
FISIOPATOLOGIA
SNS
HAS
PREVIAENDOTELIO
VASOCONSTRICCION
CRISIS HIPERTENSIVA
Cardiol Clin 24 ( 2006 ) 135 - 146
SNS
SIST
R-A-A
SECUNDARIAS
VASOCONSTRICCION
![Page 9: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/9.jpg)
PRESENTACION CLINICA
ALTERACION
SX NEUROLOGICOS
1.-ENCEFALOPATIA
5.- IAM (12%)
6.- FALLA
Cardiol Clin 24 ( 2006 ) 135 - 146
1.-ENCEFALOPATIA ( 16% )
2.- INFARTO CEREBRAL ( 24 %)
3.- HEMORRAGIA SUBARACNOIDEA (4%)
4.- HEMORRAGIA INTRACRANEAL ( 4%)
6.- FALLA VENTRICULAR IZQUIERDA
7.- EDEMA AGUDO PULMONAR ( 36%)
8.- DISECCION AORTICA (2%)
9.- RETINOPATIA
10.- IRA
11.- ECLAMPSIA (4.5%)
![Page 10: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/10.jpg)
TRIAGE
Cardiol Clin 24 ( 2006 ) 135 - 146
![Page 11: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/11.jpg)
Cardiol Clin 24 ( 2006 ) 135 - 146
![Page 12: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/12.jpg)
Cardiol Clin 24 ( 2006 ) 135 - 146
![Page 13: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/13.jpg)
TRATAMIENTO
Prim Care Clin Office Practice 35 ( 2008) 475 - 487
![Page 14: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/14.jpg)
Prim Care Clin Office Practice 35 ( 2008) 475 - 487
![Page 15: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/15.jpg)
Prim Care Clin Office Practice 35 ( 2008) 475 - 487
![Page 16: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/16.jpg)
Prim Care Clin Office Practice 35 ( 2008) 475 - 487
![Page 17: DR. ANTONIO NOLASCO RODRIGUEZ MEDICINA … · chest vol 131 issue 6 , june 2007 si la pas era mayor a 179 mmhg o pad mayor a 109 mmhg crisis hipertensiva. definiciones categoria sistolica](https://reader034.vdocuments.co/reader034/viewer/2022051601/5ad5029f7f8b9a5d058c9be4/html5/thumbnails/17.jpg)