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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
