Acute pulmonary oedema in hypertensive emergencies

A significant and abrupt rise in blood pressure (BP) can trigger acute pulmonary oedema in susceptible patients (eg patients with severe or poorly controlled heart failure). The primary aims of management of acute pulmonary oedema are to reduce afterload, myocardial workload and oxygen consumption. In patients with significantly elevated BP, these outcomes can usually be achieved by moderately reducing BP.

Intravenous glyceryl trinitrate or sodium nitroprusside are the preferred drugs to reduce elevated BP associated with acute pulmonary oedema. For dosage information, see Hypertensive emergency. See Acute cardiogenic pulmonary oedema for more detail on management.