Non-ST Elevation Acute Coronary Syndrome (NSTEACS) as Hypertension-Mediated Organ Damage (HMOD) in Hypertensive Emergencies

Hypertensive emergencies are characterized by severe increases in blood pressure with evidence of hypertension-mediated organ damage (HMOD) and associated an increased risk cardiovascular events, i.e. coronary heart disease (CHD) mortality. Case: A 75-year-old man typical chest pain nausea vomiting 1 hour before admission. Blood was 200/100 mmHg, ECG showed T inversion leads II, III, AVF, V1-V6 prolonged QT interval, cardiomegaly on x-ray, leukocytosis, hyperglycemia, hypokalemia. The diagnoses were non-ST elevation acute syndrome (NSTE-ACS), hypertensive emergency, T2DM. Treatment the ICCU consists intravenous antihypertensive, antiplatelet, anticoagulant, statin, nitrate, insulin, potassium chloride for electrolyte correction. patient admitted to further observation management.
 Hipertensi emergensi ditandai dengan kenaikan tekanan darah yang sangat disertai bukti kerusakan progresif (hypertension-mediated - HMOD). Keadaan ini berkaitan peningkatan risiko kejadian penyakit kardiovaskular, seperti jantung koroner bahkan kematian. Kasus: Seorang laki-laki usia 75 tahun nyeri dada tipikal sejak jam sebelum datang ke rumah sakit mual dan muntah. Tekanan pada EKG didapatkan inversi lead V1-V6, pemanjangan interval QT. Pada pemeriksaan X-ray kardiomegali, hasil laboratorium menunjukkan leukositosis, hiperglikemi, hipokalemi. Pasien didiagnosis hipertensi emergensi, diabetes melitus tipe 2. Tata laksana di menggunakan anti-hipertensi intravena, anti-platelet, anti-koagulan, nitrat, kalium klorida untuk koreksi elektrolit. dirawat observasi tata lebih lanjut.