Key result
High-dose IV nitroglycerin with NIPPV rapidly relieves SCAPE symptoms within ~10 minutes.
Why the study?
Sympathetic crashing acute pulmonary oedema (SCAPE) is a severe form of acute heart failure syndrome characterized by excessive sympathetic activation leading to life-threatening pulmonary oedema and respiratory failure.
Case Report (n=1)
No
Sympathetic crashing acute pulmonary oedema (SCAPE) is the most severe form of the spectrum of acute heart failure syndrome (AHFS), characterised by excessive sympathetic activation which results in very high blood pressure and redistribution of extracellular fluid causing severe pulmonary oedema, respiratory failure and death (1). This particular subset of patients present with acute onset and rapid progression of symptoms soon develops into a life-threatening condition within minutes to hours. Diagnosis of SCAPE is purely clinical and if effectively managed, the outcome is usually good (2).
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Ranasinghe et al. (2020) conducted a case report in Sympathetic crashing acute pulmonary oedema (SCAPE) (n=1). Intravenous nitroglycerin and NIPPV was evaluated on Clinical improvement (reduction in blood pressure and relief of respiratory distress). High dose intravenous nitroglycerin and non-invasive positive pressure ventilation dramatically improved symptoms and reduced blood pressure to 150/80 mmHg within 10 minutes in a patient with SCAPE.
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