Flash Pulmonary Edema (aka SCAPE)

* “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