Browse categories and answer follow-up questions to refine your symptom profile.
Immediate priorities
Stabilization and monitoring
Airway protection triggers
Agitation or inability to protect airway
Refractory hypoxemia
Breathing threats
Acute pulmonary edema
Respiratory fatigue
Circulation threats
Shock physiology despite severe hypertension
Ongoing chest pain with ischemic ECG changes
IV access and monitoring
Two large-bore peripheral IV lines
Continuous ECG monitoring
Pulse oximetry
Noninvasive BP every 2-5 minutes
Arterial line if titratable infusion anticipated
Definition and classification
Hypertensive crisis framework
Hypertensive emergency definition
Severe BP elevation with acute target-organ injury
BP threshold not required if injury present
Hypertensive urgency definition
Severe BP elevation without acute target-organ injury
Common target-organ injury domains
Central nervous system
Cardiovascular
Renal
Obstetric
Hemodynamic targets
BP reduction strategy
Standard target
Mean arterial pressure reduction 10%-20% in first hour
Additional mean arterial pressure reduction to total 25% by 24 hours
Avoided outcomes
Cerebral hypoperfusion
Myocardial ischemia from rapid afterload drop
Worsening acute kidney injury
Condition-specific targets
Aortic dissection
Systolic BP less than 120 mmHg as fast as tolerated
Heart rate less than 60 beats/min
Acute ischemic stroke not receiving thrombolysis
BP lowering only if marked elevation with symptoms or comorbid indication
Acute ischemic stroke receiving thrombolysis
BP less than 185/110 mmHg before thrombolysis
BP less than 180/105 mmHg for 24 hours after thrombolysis
Intracerebral hemorrhage
Early BP lowering with close neurologic monitoring
Preeclampsia or eclampsia
Systolic BP less than 160 mmHg
Diastolic BP less than 110 mmHg
Consultation and activation triggers
Early specialty involvement
Neurology
Focal neurologic deficit
Concern for stroke or intracranial hemorrhage
Cardiology
Acute coronary syndrome
Acute pulmonary edema with ischemia concern
Vascular surgery or cardiothoracic surgery
Suspected aortic dissection
Obstetrics
Pregnancy with severe-range BP or symptoms
Nephrology
Severe acute kidney injury
Suspected scleroderma renal crisis
Toxicology
Sympathomimetic intoxication
Withdrawal states
PEARLS
High-yield management principles
Confirm target-organ injury before aggressive BP reduction when feasible
Symptoms alone are insufficient without objective injury markers
Recheck BP with proper technique
Appropriate cuff size
Repeat manual measurement
Beta-blocker first in aortic dissection physiology
Avoid reflex tachycardia and increased shear stress from vasodilator alone
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.