PODCAST Flash Pulmonary Edema (aka SCAPE)

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• “Sympathetic Crashing Acute Pulmonary Edema”
• Pathophysiology – Rapid onset of pulmonary edema caused by sudden hypertension
  • Triggers- Missed Medication, Cocaine, Stress/Anxiety
    • Increase in BP = Increase in afterload
    • Increased afterload causes acute pulmonary edema (in patients with CHF)
    • The worsening pulmonary edema causes shortness of breath which worsens blood pressure and further increases afterload
• Presentation- Sudden, severe respiratory distress AND hypertension
  • Different than CHF exacerbation
    • Not necessarily caused by hypervolemia
    • More rapid in onset
  • Typically crackles/rales on exam or diffuse B-Lines on POCUS
• Treatment
  • BiPAP/CPAP
  • High Dose Nitroglycerin
  • Diuretics IF Hypervolemic