An aneurysm is a bulge in a blood vessel, much like a bulge on an over-inflated inner tube. Aneurysms are dangerous because they may burst. The aorta, the main artery leading away from the heart, can sometimes develop an aneurysm. Aortic aneurysms usually occur in the abdomen below the kidneys (abdominal aneurysm), but may occur in the chest cavity. This can happen if the wall of the aorta becomes weakened by build-ups of fatty deposits called plaque. This is called atherosclerosis. Aneurysms may also be due to an inherited disease such as Marfan syndrome.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Esmolol, Nitroprusside, Propranolol
Hypertension is another name for high blood pressure. This generally means that systolic blood pressure is consistently over 140 (systolic is the “top” number of your blood pressure measurement, which represents the pressure generated when the heart beats) diastolic blood pressure is consistently over 90 (diastolic is the “bottom” number of your blood pressure measurement, which represents the pressure in the vessels when the heart is at rest). Either or both of these numbers may be too high.
Commonly Prescribed (On-Label) Drugs: Acebutolol, Amiloride, Amlodipine, Amlodipine/Atorvastatin, Amlodipine/Benazepril, Apraclonidine, Atenolol, Atenolol/Chlorthalidone, Benazepril, Bendroflumethiazide, Benzthiazide, Betaxolol, Bisoprolol, Bisoprolol/Hydrochlorothiazide, Bosentan, Candesartan, Candesartan/Hydrochlorothiazide, Captopril/ Hydrochlorothiazide, Carteolol, Carvedilol, Chlorothiazide, Chlorthalidone, Cyclothiazide, Delapril, Deserpidine, Diazoxide, Doxazosin, Enalapril, Enalapril/Hydrochlorothiazide, Eplerenone, Epoprostenol, Eprosartan, Eprosartan/Hydrochlorothiazide, Fenoldopam, Fosinopril, Furosemide, Guanabenz, Guanadrel, Guanethidine, Guanfacine, Hydralazine, Hydrochlorothiazide, Hydroflumethiazide, Iloprost, Indapamide, Irbesartan, Irbesartan/Hydrochlorothiazide, Isradipine, Labetalol, Latanoprost, Lisinopril, Lisinopril/Hydrochlorothiazide, Losartan, Losartan/Hydrochlorothiazide, Mannitol, Mecamylamine, Methyclothiazide, Methyldopa, Metolaone, Metoprolol, Mibefradil, Minoxidil, Moexipril, Nadolol, Nitric Oxide, Nitroprusside, Olmesartan, Olmesartan/Hydrochlorothiazide, Penbutolol, Phentolamine, Pindolol, Polythiazide, Prazosin, Propranolol, Quinapril, Quinethazone, Ramipril, Rescinnamine, Reserpine, Saralasin, Spironolactone, Telmisartan, Telmisartan/ Hydrochlorothiazide, Terazosin, Thiopental, Timolol, Tolazoline, Torsemide, Trandolapril, Trandolapril/Verapamil, Treprostinil, Triamterene/Hydrochlorothiazide, Trichlormethiazide, Trimethaphan, Valsartan, Valsartan/ Hydrochlorothiazide, Verapamil
Off-Label Prescription Drug Breakthrough Option: Ethacrynic Acid
Hypertensive crisis is a severe increase in blood pressure that can lead to a stroke. Extremely high blood pressure, greater than 180/110 millimeters of mercury, can damage blood vessels. Blood vessels become inflamed and may leak fluid or blood. As a result, the heart may not be able to pump blood efficiently. Hypertensive crisis, both “emergency” and “urgent,” requires immediate medical attention. A crisis requires immediate hospitalization in an intensive care unit with immediate treatment.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Captopril, Nitroglycerin IV
Orthostatic hypotension is a sudden fall in blood pressure that occurs when a person assumes a standing position. It may be caused by hypovolemia (a decreased amount of blood in the body), resulting from the excessive use of diuretics, vasodilators or other types of drugs, dehydration, or prolonged bed rest. The disorder may be associated with a variety of medical disorders. Symptoms, which generally occur after sudden standing, include dizziness, lightheadedness, blurred vision, and syncope (temporary loss of consciousness).
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Fludrocortisone
Peripheral arterial disease (also called PAD) refers to a problem with blood flow in the arteries. Your arteries carry blood to the muscles and organs in the body. When the arteries are affected, they become narrow or blocked. The most common cause of narrow or blocked arteries is the buildup of fatty deposits. This is called atherosclerosis. The most common complaint of people who have PAD is claudication (a pain in the calf or thigh muscle that occurs after walking a certain distance, perhaps a block or two. The pain stops after rest).
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Lovastatin, Pravastatin, Simvastatin, Warfarin
A pulmonary embolism is a blood clot that travels to the lungs. Often, the clot forms in another part of the body, usually in the veins of the legs. Large clots can be fatal. Pulmonary embolism is estimated to occur in one to two people per 1,000 each year in the United States.
Commonly Prescribed (On-Label) Drugs: Alteplase, Dextran, Fondaparinux, Heparin, Streptokinase, Urokinase
Off-Label Prescription Drug Breakthrough Option: Isoproterenol
High blood pressure in the arteries that supply the lungs is called pulmonary hypertension (PHT). The blood pressure measured by cuff on the arm is not directly related to the pressure in the lungs.The blood vessels that supply the lungs constrict and their walls thicken, so they are unable to carry as much blood as needed. As in a kinked garden hose, pressure builds up and backs up. The heart works harder, trying to force the blood through. If the pressure is high enough, eventually the heart will not be able to keep up and the amount of blood circulating through the lungs is reduced resulting in reduced oxygen. You may then become tired, dizzy, and short of breath.
Commonly Prescribed (On-Label) Drugs: Bosentan, Epoprostenol, Iloprost, Nitric oxide, Tolazoline, Treprostinil
Off-Label Prescription Drugs Breakthrough Options: Hydralazine, Sildenafil, Tadalafil, Vardenafil
Up to one fifth of the adult population has Raynaud’s syndrome. In response to cold or stress, the fingers of patients with Raynaud’s syndrome undergo characteristic circulatory changes. The fingers typically become white, caused by vasoconstriction, then blue, caused by capillary stagnation and, finally, red. Women are more commonly affected than men and the condition may be familial or associated with connective tissue diseases such as scleroderma or lupus. Raynaud’s syndrome can be classified as primary or secondary. Primary Raynaud’s syndrome is characterized in patients that have no other underlying disease or causes such as connective tissue disease. Secondary Raynaud’s syndrome, although less common but more complex and serious, occurs in patients who have an underlying disease that causes this syndrome.
Commonly Prescribed (On-Label) Drugs: Isoxsuprine
Off-Label Prescription Drugs Breakthrough Options: Amlodipine, Captopril, Diltiazem, Felodipine, Clonidine, Fluoxetine, Losartan, Nicardipine, Nifedipine, Nitroglycerin (topical), Prazosin, Verapamil
Attack Severe hypertension is elevated blood pressure not yet leading to significant organ damage. In these patients, the hypertension does not necessarily require treatment during an emergency department visit but does require close follow-up with a primary care physician for long-term blood pressure control. In these cases, beginning antihypertensive therapy in the emergency department may be appropriate and should be done in consultation with your primary care physician, who will be caring for you after the visit. Severe hypertension is also referred to as Stage 3 hypertension and the blood pressure range is: systolic 180 to 209 mm Hg (top number), and diastolic 110 to 119 mm Hg (bottom number).
Commonly Prescribed (On-Label) Drugs: Fenoldopam
Off-Label Prescription Drug Breakthrough Option: Nitroglycerin IV
Angina is a pain or discomfort in the chest and is caused by insufficient blood flow to the heart. Symptoms include tightness, heavy pressure, squeezing, pain, or crushing chest pain. Angina affects 3 to 5% of the population and can be alleviated through rest or medication within a short period of time, usually within fifteen minutes.
Commonly Prescribed (On-Label) Drugs: Bepridil
Off-Label Prescription Drug Breakthrough Option: Acebutolol
A stroke occurs when there is insufficient blood supply to the brain, causing brain tissue to be deprived of nutrients. Strokes are the third-leading cause of death in the United States, affecting nearly 700,000 Americans annually. Symptoms include sudden numbness, weakness, loss of speech, blurred vision, and confusion. Medical treatment should be sought immediately for anyone experiencing a stroke.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Fluoxetine
The brain is an extremely complex organ that controls various body functions. If a stroke occurs, blood flow may not be able to reach the region that controls a particular body function. Knowing the risk and controlling what is possible (weight and diet for example) is your best defense against having a stroke. Both coronary heart disease and stroke share many of the same risk factors such as cholesterol disorders, high blood pressure, smoking, diabetes, physical inactivity, and being overweight or obese.
Commonly Prescribed (On-Label) Drugs: Aspirin, Aspirin/Dipyridamole, Dipyridamole, Losartan, Pravastatin, Ramipril
Off-Label Prescription Drugs Breakthrough Options: Captopril, Low Molecular Weight Heparin, Warfarin
Thrombolysis is the treatment to break up abnormal blood clots that are restricting blood flow. Thrombolytic therapy dissolves these blood clots using various medications administered directly into the clot through a catheter. Thrombectomy is the disruption of a blood clot using one of several mechanical devices. One or both of these methods can be used to dissolve and remove blood clots. Thrombolysis can greatly improve blood flow and reduce or eliminate the related symptoms and effects without the need for more invasive surgery.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Warfarin
Transient ischemic attack is a brief episode in which the brain gets insufficient blood supply. The symptoms vary depending on the area where the blockage occurs but can include sudden numbness or weakness in the face, arm or leg, confusion or trouble speaking, severe headaches, and dizziness. Transient ischemic attack is a critical sign of impending stroke. Failure to quickly recognize and evaluate this warning sign could mean you are missing an opportunity to prevent permanent disability or death. The 90-day risk of stroke after a transient ischemic attack has been estimated to be approximately 10 percent, with one half of strokes occurring within the first two days of the attack. The 90-day stroke risk is even higher when a transient ischemic attack results from a narrowing of the carotid artery.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Warfarin
Chest pain that persists for a long period of time or that occurs with a lower level of effort, even at rest, is classified as unstable angina. This is a serious form of angina, and anyone experiencing it should seek emergency care immediately.
Commonly Prescribed (On-Label) Drugs: Dalteparin, Enoxaparin
Off-Label Prescription Drugs Breakthrough Options: Esmolol, Low Molecular Weight Heparin, Lepirudin
A simple faint (vasovagal syncope) occurs due to an exaggerated response by the nervous system. As a result, heart rate and blood pressure drop, which reduces blood flow to the brain and leads to fainting. In some cases, the cause of a simple faint cannot be determined. But common triggers include: standing for long periods, dehydration, coughing, urination, having a bowel movement, and emotional distress.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Fluoxetine, Paroxetine
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