REFARAT

“CRISIS HYPERTENSION”

ARRANGED BY:

Salman Saisar Hidayat 2011730095

PRESEPTOR :

dr Ihsanil Husna, Sp.PD

STASE ILMU PENYAKIT DALAM RSIJ CEMPAKA PUTIH

PROGRAM STUDI KEDOKTERAN

FAKULTAS KEDOKTERAN DAN KESEHATAN

UNIVERSITAS MUHAMMADIYAH JAKARTA

2016

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KATA PENGANTAR

AssalamualaikumWr. Wb.

Alhamdulillah, Puji syukur penyusun panjatkan kehadiran ALLAH SWT atas

terselesaikannya tugas Refarat “Krisis Hipertensi”.

Makalah refreshing ini disusun dalam rangka untuk dapat lebih mendalami dan

memahami mengenai “Krisis Hipertensi” . Tujuan khususnya adalah sebagai pemenuhan tugas

kepaniteraan Stase Ilmu Penyakit Dalam.

Semoga dengan adanya laporan kasus ini dapat menambah khasanah ilmu pengetahuan

dan berguna bagi penyusun maupun peserta didik lainnya.

Penyusun menyadari bahwa laporan kasus ini masih jauh dari kesempurnaan, oleh karena

itu penyusun sangat membutuhkan saran dan kritik untuk membangun laporan kasus yang lebih

baik di masa yang akan datang.

Terimakasih.

WassalamualaikumWr. Wb

Jakarta, Mei 2016

Penulis

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a. Definition

Hypertensive crises are defined as levels of systolic blood pressure >180 mmHg and/

or levels of diastolic blood pressure >120 mmHg and are mainly found in patients

with essential artery hypertension.

b. Epidemiology

In an Italian multicenter study of 1,546 patients with hypertensive crises, 13 % of

men and 9 % of women reported not taking antihypertensive drugs. Hypertensive

emergencies represented 25 % of crises. Approximately 25 % of adults with chronic

hypertension were unaware of their disease. In the US parallels the distribution of

essential hypertension with a twofold higher incidence in African–Americans than in

whites.

c. Classification

Hypertensive urgency is a situation with a severe increase in blood pressure without

progressive dysfunction of target organs.

Hypertensive emergencies are life threatening states because their outcome is

complicated by acute damages of target organs.

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d. Etiology

Undiagnosed or untreated hypertension is the most important risk factor to be crises

hypertension. Genetic factor, lifestyle, diet, acute physical stress, chronic

physiological stress can be the causes of hypertension. So the primary treatment is to

change the risk factor that can make hypertension.

e. Pathophysiology

Pathophysiology of hypertensive crises is still unclear. From the aspect of

pathophysiology, the disorder of systemic blood flow auto regulation on the level of

arterioles is considered to be a cause for both forms of hypertensive crisis.

f. Clinical manifestaions

Hypertensive urgency is a situation with severe increase in blood pressure without

progressive dysfunction of vital organs. The most common symptoms are headache,

dyspnea, nausea, vomiting, epistaxis, and pronounced anxiety.

Hypertensive emergencies include hypertensive encephalopathy, hypertensive acute

left ventricular relaxation associated with acute myocardial infarction or unstable

angina, aortic dissection, subarhnoic hemorrhage, ischemic stroke, and severe

preeclampsia or eclampsia.

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g. Supporting examinations

Recommended testing includes the following:

• Hematologic routine

• Blood glucose

• Total cholesterol serum

• Serum uric acid

• Creatinin serum

• Kalium serum

• Urinalisis

• Electrocardiogram

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h. Treatment

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References

• Monnet, Xavier, Paul E. Marik. 2015. What’s new with hypertensive crises?.

Intensive Care Med. 41:127–130

• Salkic, Sabina, Olivera Batic-Mujanovic, Farid Ljuca, Selmira Brkic. 2014.

Clinical Presentation of Hypertensive Crises in Emergency Medical Services.

Mater Sociomed. 26(1): 12-16

• Salkic, Sabina, Selmira Brkic, Olivera Batic-Mujanovic, Farid Ljuca, Almedina

Karabasic, Sehveta Mustafic. 2015. Emergency Room Treatment of Hypertensive

Crises. Med Arh, 69(5); 302-306

• Current Medical Diagnosis & Treatment. Systemic Hypertension. Sutters,

Michael.MD. 2016. 435-467

• American Journal of Emergency Medcine. The Relationship between vascular

inflammation and target organ damage in hypertensive crises. Karaback, Mustafa

MD. 2015; 497-500

• Jose Roesma. Krisis Hipertensi. Sudoyo, Idrus Alwi editor. Buku Ajar Ilmu

Penyakit Dalam Jilid II Edisi VI. Pusat penerbitan departemen penyakit dalam

FKUI.2014

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