(精编)【高血压英文教学精品课件】 HYPERTENSION AND VASCULAR DISEASES.pptVIP

Features of Septic Shock fever chills hypotension Hyperglycemia and altered mental status due to gram-negative bacteremia: (E coli, Klebsiella, Proteus, and Pseudomonas) Hypotension systolic blood pressure of 90 mm Hg or less A drop in systolic pressure of more than 10–20 mm Hg and an increase in pulse of more than 15 with positional change Treatment General Measures Basic life support-(BLS) airway/oxygen/cpr Advanced Cardiac Life Support – (ACLS) Orthostatic Hypotension Vasomotor Syncope Elderly Diabetics greater than normal decline (20 mm Hg) in blood pressure immediately upon arising from the supine to the standing position VASCULAR DISORDERS Aneurysms of Abdominal Aorta AAA Most aortic aneurysms are asymptomatic, detected during a routine physical examination or a diagnostic study. Severe back or abdominal pain, a pulsatile mass, and hypotension indicate rupture. Concomitant atherosclerotic occlusive disease of the lower extremities is present in 25% of patients. Signs of HTN Heart: Left ventricular enlargement/Hypertrophy LAB workup: CBC/Urinalysis/FBS/LIPIDS/ Serum Uric Acid /Electrolytes/Creatinine/ BUN ECG/CXR Basic Testing in the Hypertensive Patient ??Primary work-up (all patients) Urinalysis and sediment review (identifies possible renal disease or end-organ dysfunction) Basic chemistry including potassium, fasting glucose, blood urea nitrogen, and creatinine (evaluates for renal disease; low or low-normal potassium may be seen in hyperaldosteronism; fasting glucose can assess for diabetes) Complete blood cell count (evaluates for polycythemia, which can cause secondary hypertension) Lipid panel(risk stratification for patients with dyslipidemia) Electrocardiogram (risk stratification in patients with coronary artery disease; evaluate for left ventricular hypertrophy  Goals of the Initial Evaluation Establish the diagnosis. Staging the disease. If present, hypertension is staged using the criteria outlined in the JNC 7 consen