Cardiovascular System

Cardiovascular Anatomy & Physiology

Arterial Disease in Critical Illness

Cardiac Assist Devices: General Principles

Cardiac Ischemia, Arrhythmias

Hypertension and Hypertensive Emergencies

Preoperative Evaluation of Cardiac Risk

Cardiac Valvular Disease

Types of Cardiac Failure and Treatment

Types of Shock

Invasive Hemodynamic Monitoring

Mechanical Support Devices including IABP, ECMO

Techniques for Closed and Open Cardiac Compression, Pericardiocentesis

Endpoints of Resuscitation

Inotropic and Vasopressor Agents

Pacemakers

hypertensive emergency

diagnosis
- sBP ≥ 180 and/or dBP ≥ 120
- evidence of end-organ damage incl.
  1. AMS, n/v, papilledema
  2. chest pain, ischemia on ECG
  3. dyspnea, pulmonary edema
  4. oliguria, AKI
therapy
- reduce MAP by 10-20% over 1h
- reduce by 25% from baseline over next 23h
- nitroprusside or clevidipine or labetalol ggt
- exceptions to rapid reduction of MAP during HTN emergency incl.
  1. acute phase of ischemic stroke: the blood pressure is usually not lowered unless it is ≥ 185/110 in patients who are candidates for reperfusion therapy or ≥ 220/120 in patients who are not candidates for reperfusion therapy
  2. acute aortic dissection: the systolic blood pressure is rapidly lowered to a target of 100-120 mmHg (to be attained in 20 minutes)
  3. spontaneous hemorrhagic stroke: the systolic blood pressure can be rapidly reduced if no contraindications exist

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