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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
- Triggers- Missed Medication, Cocaine, Stress/Anxiety
- 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
- Different than CHF exacerbation
- Treatment
- BiPAP/CPAP
- High Dose Nitroglycerin
- Diuretics IF Hypervolemic