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Colegio de Medicina Interna de México.

2014, Número 6

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Med Int Mex 2014; 30 (6)


Hipertensión arterial severa en urgencias. Una evaluación integral

Fonseca RS

Idioma: Español
Referencias bibliográficas: 40
Paginas: 707-717
Archivo PDF: 500.47 Kb.


RESUMEN

Es muy frecuente observar a pacientes que acuden a las unidades de urgencias con presión arterial alta severa asintomática o con diversas manifestaciones clínicas que generan cierta confusión para identificar si la hipertensión arterial es causa o consecuencia del trastorno clínico por el que consulta un paciente. Debido a la caótica situación y sobresaturación de los servicios de urgencias de muchas clínicas y hospitales y la carencia de guías nacionales o internacionales específicas para la atención de estos pacientes, con frecuencia no son evaluados de manera adecuada y, en ocasiones, reciben tratamiento indebido o insuficiente. El término crisis hipertensiva aún se utiliza de manera genérica para identificar a individuos con presión arterial alta severa, pero se invierte poco esfuerzo para clasificarlos correctamente de acuerdo con si existe o no daño cardiovascular concomitante. Son tres las situaciones clínicas que se deben diferenciar: hipertensión severa descontrolada, urgencia hipertensiva y emergencia hipertensiva, para elegir el tratamiento más apropiado para reducir la presión arterial, debido a que cada escenario clínico implica un seguimiento y pronóstico distintos.


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