1. For various hypertensive emergencies such as malignant hypertension, hypertensive crisis, hypertensive encephalopathy or hypertensive complications with dissection of the aorta (formation of an aneurysm), sodium nitroprusside should be the first choice; it can also be used for postoperative reactive hypertension in cardiac surgery.
2. Acute left-sided heart failure and pulmonary edema: Sodium nitroprusside should be used as early as possible in hypertensive patients with acute left-sided heart failure and pulmonary edema; for acute myocardial infarction with left-sided heart failure that has occurred more than 8 hours after the onset of the disease and has not responded to conventional treatment, sodium nitroprusside may be considered.
3. Refractory heart failure: Sodium nitroprusside can be used in combination with dobutamine for "shock therapy" for several days to treat refractory heart failure caused by various etiologies; this often leads to improvement in symptoms, and the effect may last for several weeks.
4. Acute mitral and aortic valve insufficiency, interventricular septal perforation: After the use of sodium nitroprusside, the forward blood flow resistance is reduced, and the reverse flow and left-to-right shunting can be reduced, which can alleviate the condition and can be used as a preparation for surgery.
