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Vascular Emergencies

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Emergency Department Critical Care

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Abstract

Vascular emergencies require time-sensitive therapy that determines whether patients live, survive with poor functional outcome, or ultimately die. Because of the high consequences associated with their care, acute aortic syndromes, ischemic limbs, and mesenteric ischemia demand the same attention required for acute ischemic strokes (i.e., CNS vascular emergencies) or ST elevation myocardial infarctions (i.e., coronary vascular emergencies). Some presentations are dramatic – a cold, white extremity is not a difficult diagnosis – while other presentations are woefully nonspecific; altered mental status in a patient with hypotension and a rising lactate does not secure a diagnosis of mesenteric ischemia over cardiogenic or septic shock.

Another hallmark of vascular emergencies is that although we must rely on our consultants for definitive management, our initial actions greatly determine patient outcomes. This chapter presents crucial steps and guidelines for the care of patients with acute mesenteric ischemia, limb ischemia, and abdominal aortic aneurysm rupture (aortic dissection is discussed in Chap. 13). We in the emergency department are the first line of defense against such illness and, therefore, must be prepared if we are to optimize outcomes.

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Authors and Affiliations

  1. Departments of Medicine and Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Michael T. McCurdy & Kami Hu

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  1. College of Medicine, University of Florida Health Science Center, Jacksonville, FL, USA

    Joseph R. Shiber

  2. Resuscitation & Emergency Critical Care, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Scott D. Weingart

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McCurdy, M.T., Hu, K. (2020). Vascular Emergencies. In: Shiber, J., Weingart, S. (eds) Emergency Department Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-28794-8_16

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