CRISIS HIPERTENSIVA

JORGE LUIS OSORIO PERDOMO

de la Fuente G de A, del Valle KMP, Gaitán Tocora DG, Sevillano BH. Protocolo diagnóstico y tratamiento de las crisis hipertensivas. Medicine [Internet].
2019;12(81):4804–6. Disponible en: http://dx.doi.org/10.1016/j.med.2019.06.009

Cardona MF, Roldán IM, Soriano AS, Molinero VP. Protocolo diagnóstico y terapéutico de las crisis hipertensivas en Urgencias. Medicine [Internet].
2015;11(90):5399–403. Disponible en: http://dx.doi.org/10.1016/j.med.2015.11.007
 UpToDate [Internet]. Uptodate.com. [citado el 12 de noviembre de 2023]. Disponible en:
https://www.uptodate.com/contents/evaluation-and-treatment-of-hypertensive-emergencies-in-adults?search=crisis%20hipertensiva&source=search_res
ult&selectedTitle=1~150&usage_type=default&display_rank=1

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur
Heart J [Internet]. 2018;39(33):3021–104. Disponible en: http://dx.doi.org/10.1093/eurheartj/ehy339
 Definicion

Crisis Urgencia Emergencia

TA superior a 180/120 TA superior a 180/120 TA superior a 180/120
mm Hg mm Hg mm Hg
CON Daño en órgano SIN Daño en órgano CON Daño en órgano
blanco blanco blanco

de la Fuente G de A, del Valle KMP, Gaitán Tocora DG, Sevillano BH. Protocolo diagnóstico y tratamiento de las crisis hipertensivas. Medicine [Internet].
2019;12(81):4804–6. Disponible en: http://dx.doi.org/10.1016/j.med.2019.06.009
 Epidemiologia

HTA Urg y Emer

450,1 por cada 1000 91.7% Urgencia
habitantes 72% 8.2% Emergencia

CUBA
Estudio longitudinal
y prospectivo del
2018 a 2019
45% Prevalencia 75%
Region Cienfuegos 50 a 59 años
Sexo masculino
Fumadores 72.6%
Diabeticos 39.7%
Utrera Díaz Grissel, Pérez Rodríguez Lianet, Toledo Yanes Pedro. Crisis hipertensivas: caracterización clínico-epidemiológica y estratificación de riesgo cardiovascular. Rev. Finlay [Internet]. 2021 Sep [citado 2023 Nov 12] ;
11( 3 ): 233-242. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2221-24342021000300233&lng=es. Epub 30-Sep-2021.
 Presentaciones típicas

HTA maligna Secundario a Efecto rebote Embarazo

Cambios en Disección aórtica

fondo de ojo Isquemia Con la retirada
Encefalopatia 15% miocardica de los fármacos Preeclampsia
IC aguda aortica antihipertensivos.
IRA Feocromocitoma

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J [Internet].
2018;39(33):3021–104. Disponible en: http://dx.doi.org/10.1093/eurheartj/ehy339
 Clinica y diagnostico
Anamnesis

Toma PA TA superior a 180/120 mm Hg

Cefalea, alteraciones visuales,

dolor torácico, disnea y vértigo
Clinica
Organo dependiente

Fondo de ojo, auscultacion de

Examen ruidos cardiacos, campos
fisico pulmonares y
neurológico completo
examen

Cardona MF, Roldán IM, Soriano AS, Molinero VP. Protocolo diagnóstico y terapéutico de las crisis hipertensivas en Urgencias. Medicine [Internet]. 2015;11(90):5399–403.
Disponible en: http://dx.doi.org/10.1016/j.med.2015.11.007
 Paraclinicos

Cardona MF, Roldán IM, Soriano AS, Molinero VP. Protocolo diagnóstico y terapéutico de las crisis hipertensivas en Urgencias. Medicine [Internet]. 2015;11(90):5399–403.
Disponible en: http://dx.doi.org/10.1016/j.med.2015.11.007
 Tratamiento de urgencia
1 2

NO dar de forma sublingual

Dar VO
Se espera una reducción de la
TAM del 20% en 24 a 48h y un
reducción del TA no menor
160/100 mmHg

Cardona MF, Roldán IM, Soriano AS, Molinero VP. Protocolo diagnóstico y terapéutico de las crisis hipertensivas en Urgencias. Medicine [Internet]. 2015;11(90):5399–403.
Disponible en: http://dx.doi.org/10.1016/j.med.2015.11.007
 Tratamiento de urgencia

Cardona MF, Roldán IM, Soriano AS, Molinero VP. Protocolo diagnóstico y terapéutico de las crisis hipertensivas en Urgencias. Medicine [Internet]. 2015;11(90):5399–403.
Disponible en: http://dx.doi.org/10.1016/j.med.2015.11.007
 Tratamiento de Emergencia

Reducir 20% PA en 30 a 120 min

Reducir 10% en 24 a 48 h

Disección aórtica se buscan un

mayor descenso

Cardona MF, Roldán IM, Soriano AS, Molinero VP. Protocolo diagnóstico y terapéutico de las crisis hipertensivas en Urgencias. Medicine [Internet]. 2015;11(90):5399–403.
Disponible en: http://dx.doi.org/10.1016/j.med.2015.11.007
 Tratamiento de Emergencia

Organo Blanco cerebro

ACV isquémico No reducir TA

excepto si la TA es superior a
220/120 mmHg

ACV Hemorragico TAM por

encima de 130 mmHg con un
PIC mayor a 60 mmHg

Cardona MF, Roldán IM, Soriano AS, Molinero VP. Protocolo diagnóstico y terapéutico de las crisis hipertensivas en Urgencias. Medicine [Internet]. 2015;11(90):5399–403.
Disponible en: http://dx.doi.org/10.1016/j.med.2015.11.007
 Tratamiento de Emergencia

Organo blanco sistema

cardiovasculares

Disección aórtica
PAS menor a 120 mmHg
FC menor a 60
30 min

SCA
Disminuir demanda de O2
Betabloqueadores y
Nitroglicerina

Cardona MF, Roldán IM, Soriano AS, Molinero VP. Protocolo diagnóstico y terapéutico de las crisis hipertensivas en Urgencias. Medicine [Internet]. 2015;11(90):5399–403.
Disponible en: http://dx.doi.org/10.1016/j.med.2015.11.007
 Tratamiento de Emergencia
Organo blanco

Eclampsia y preeclampsia
Extracción del feto y sulfato de magnesio

Hipertensión arterial acelerada o maligna

IECA y labetalol

Síndromes hiperadrenérgicos
Bloqueadores de los canales del calcio

Cardona MF, Roldán IM, Soriano AS, Molinero VP. Protocolo diagnóstico y terapéutico de las crisis hipertensivas en Urgencias. Medicine [Internet]. 2015;11(90):5399–403.
Disponible en: http://dx.doi.org/10.1016/j.med.2015.11.007
 Tratamiento de urgencia

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J [Internet].
2018;39(33):3021–104. Disponible en: http://dx.doi.org/10.1093/eurheartj/ehy339
 Tratamiento de urgencia

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J [Internet].
2018;39(33):3021–104. Disponible en: http://dx.doi.org/10.1093/eurheartj/ehy339
 Tratamiento de urgencia

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J [Internet].
2018;39(33):3021–104. Disponible en: http://dx.doi.org/10.1093/eurheartj/ehy339
GRACIAS
 Clinica y diagnostico

Mars Neptune
Mars is actually a It’s the farthest
50% very cold place
25% planet from the Sun

Jupiter 10% Mercury 75%

It’s the biggest It’s the closest
planet of them all planet to the Sun
 Introduction
You can give a brief description of the
topic you want to talk about here. For
example, if you want to talk about
Mercury, you can say that it’s the smallest
planet in the entire Solar System
 Identifying information

Mercury Venus Mars

It’s the closest planet It has a beautiful Mars is actually a
to the Sun and the name and very high cold place. It’s full of
smallest one temperatures iron oxide dust
 How to detect hypertension?

Venus is the second

Venus planet from the Sun

Jupiter is the biggest

Jupiter planet of them all

It’s composed of
Saturn hydrogen and helium

Mars is actually a very

Mars cold place

It’s the closest planet

Mercury to the Sun
 01
What is
hypertension?
You can enter a subtitle here if you need it
A picture is worth
a thousand words
 “This is a quote, words full of
wisdom that someone important
said and can make the reader
get inspired.”

—Someone Famous
 Countries with the highest incidences
Mercury
75% It’s the closest
planet to the Sun

Mars
50% Mars is actually a
very cold place

50,000,363
total cases
 Treatment

01 Mercury
It’s the closest planet to
the Sun and the smallest
in the Solar System

02 Venus
Venus has a beautiful
name and is the second
planet from the Sun
Awesome
words
150,000
Big numbers catch your audience’s attention
 Symptoms
Mercury Jupiter
It’s the closest planet Jupiter is the biggest
to the Sun planet of them all

Venus Saturn
Venus is the second Saturn is composed
planet from the Sun of hydrogen

Mars Neptune
Mars is actually a It’s the farthest
very cold place planet from the Sun
 Other symptoms
you should know
Mercury is the closest planet to the Sun and
the smallest one in the Solar System. This
planet's name has nothing to do with the
liquid metal, since Mercury was named
after the Roman messenger god
 Findings
Evolution Jupiter
Jupiter is the biggest planet of them all

Neptune
It’s the farthest planet from the Sun

Saturn
It’s a gas giant and has several rings

125,000
Follow the link in the graph to modify its data and then Big number
paste the new one here. For more info, click here
 Expert recommendations
Jupiter 20%
Jupiter is the biggest planet of them all

Neptune 80%
It’s the farthest planet from the Sun

Venus Mercury
75% Venus is the second It’s the smallest
50%
planet from the Sun planet of them all
 Physical examination

Venus Jupiter
01 Venus is the second It’s the biggest planet 02
planet from the Sun in the Solar System

Mars Saturn
03 Despite being red, Saturn is a gas giant 04
Mars is a cold place and has several rings
 Comparaison

Symptoms Venus Mars Jupiter

Venus is the second
Yes Yes No
planet from the Sun

Saturn is composed of
Yes No Yes
hydrogen and helium

Jupiter is the biggest

No No Yes
planet of them all
 Disease evolution

Year 1 Year 2 Year 3 Year 4

Mercury is the Jupiter is the Mars is actually a Neptune is very

smallest planet biggest planet very cold place far from the Sun
 Alternative treatments

Mercury Venus Mars

Mercury is the closest Venus is the second Mars is actually a very
planet to the Sun planet from the Sun cold place

Jupiter Saturn Neptune

Jupiter is the biggest It’s composed of It’s the farthest planet
planet of them all hydrogen and helium from the Sun
 04
How to prevent
hypertension?
You can enter a subtitle here if you need it
 Preventions

Dr. Lisa Jones Dr. Louis Smith

“Mercury is the closest “Neptune is the farthest
planet to the Sun and planet from the Sun. It's
the smallest of them all” also the fourth-largest”

Dr. John Lewis Dr. Jena Doe

“Venus has a beautiful “Mars is full of iron oxide
name and is the second dust, which gives the
planet from the Sun” planet its reddish cast”
 Post-preventions

Mars Neptune
Mars is actually a It’s the farthest
50% very cold place
25% planet from the Sun

Jupiter 10% Mercury 75%

It’s the biggest It’s the closest
planet of them all planet to the Sun
 Contraindications and indications

You shouldn’t You should

● Describe the things patients
should do here
● Describe the things patients
should do here
● Describe the things patients
should do here
● Describe the things patients
should do here
● Describe the things patients
should do here
● Describe the things patients
shouldn't do here
● Describe the things patients
shouldn't do here
● Describe the things patients
shouldn't do here
● Describe the things patients
shouldn't do here
● Describe the things patients
shouldn't do here
 Research in progress
Mercury 2005 Jupiter 2017
It’s the closest It’s the biggest
planet to the Sun planet of them all

Mars 2010 Pluto 2019

Despite being red, It’s now considered
Mars is a cold place a dwarf planet

Venus 2015 Neptune 2021

Venus is the second It’s the farthest
planet from the Sun planet from the Sun
 50% 20,000
Despite being red, Venus is the second
Mars is a cold place planet from the Sun

150,000 75%
Mars is actually a Neptune is very far
very cold place from the Sun
 Conclusions
Venus has a beautiful name and is the second
planet from the Sun. It’s terribly hot, even hotter
than Mercury, and its atmosphere is extremely
poisonous. It’s the second-brightest natural object
in the night sky after the Moon
 Our team

Timmy Jimmy Jenna Doe

You can speak a bit You can speak a bit
about this person here about this person here
More information
in our web
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