Hypertensive crisis - the sudden state of the rapid increase in blood pressure to the critical values, which is accompanied by severe and intensive symptomatic picture of the high risk of dangerous consequences. Krizovoe of essential hypertension - a dangerous phenomenon for human health and life, requires immediate provision of medical care and appropriate therapy.
Causes
Main causes a hypertensive crisis - the presence of diseases and pathologies, for which is accompanied by hypertension. In 30% of cases there is a pathological condition of chronic hypertension. Affected Creasy women over 45 years, with the onset of menopause. Other diseases that are the causes of attack, are accompanied by major blood vessels - aortas. These include:
- glomerulonephritis;
- nephroptosis;
- pyelonephritis;
- renal nephropathy in diabetes mellitus;
- systemic lupus erythematosus;
- nephropathy in pregnant women;
- Cushing's disease;
- pheochromocytoma.
Crisis may occur due to a sudden discontinuation of medications hypotensive groups. Risk factors that trigger the emergence of a crisis:
- excessive exercise;
- the presence of harmful habits (smoking, frequent consumption of alcoholic beverages);
- severe hypothermia;
- improper diet (lots of fatty foods, drinking plenty of salt and spices);
- stress;
- psychological, emotional exhaustion;
- meteosensitivity presence;
- alcohol intoxication;
- obesity;
- insomnia;
- men - long-term use of drugs that affect the potency;
- Chronic lack of sleep;
- changing climatic conditions;
- mental strain, depression;
- dystonia;
- low back pain;
- Drinking large amounts of coffee.
Hypertensive heart disease and diseases accompanied by disruption of the functioning of the aorta - is not the only factors that lead to the development of the crisis. Lead to pressure instability may also deviation in the endocrine system - the presence of hyperthyroidism or diabetes, previous stroke, heart attack, disruptions in the hormonal system, traumatic brain injury.
Hypertensive attack - reaction to the disturbed circulation process due to dysfunction and impaired condition of the blood vessels.
Classification
Hypertensive crises are divided into types according to the degree of severity and intensity of the symptomatic picture. Classification crisis mechanism jumps in blood pressure:
- Hyperkinetic - peripheral vascular tone is maintained in a normal state, a pressure drop caused by the increase in ejection of blood by the heart muscle.
- Hypokinetic - cardiac output drops against the backdrop of increased peripheral vascular resistance.
- Eukinetic type - cardiac output is maintained in a normal state, increased vascular tone, because of what the increased diastolic and systolic blood pressure.
Types of crisis by the nature of the clinical manifestations:
- Uncomplicated - the clinical picture of moderate. Uncomplicated crises quickly cease medicines, are not accompanied by consequences. Characterized uncomplicated crisis is a sudden rise in pressure, accompanied by headaches, frequent urination, shortness of breath and chest soreness.
- Complicated - there is symptomatic picture of violations of state and functioning of the internal organs. In the absence of timely medical assistance complicated crisis can lead to heart attack and stroke.
Depending on what the nature of the clinical picture is dominated by complicated crisis is autonomic, spasmodic and swollen. Localization of the affected area in the body where there were consequences, complicated crisis is renal, vascular, cardiac and cerebral.
What are the symptoms
Common symptoms of the attack:
- dizziness;
- pain in the chest;
- decreased visual acuity;
- fever;
- deterioration of the general condition;
- noise and hum in his ears;
- severe headache, localized in the neck;
- profuse sweating.
Symptomatology of the approaching crisis:
- the sudden appearance of intense pain in the head;
- blurred vision;
- redness of the skin on the face and neck;
- pressing character pain in the sternum;
- nausea and vomiting;
- rapidly deteriorating overall health.
Neurovegetative type of crisis is manifested by the following features:
- profuse sweating;
- increased nervousness and irritability;
- redness of the skin on the neck and face;
- dryness of mucous membranes in the mouth;
- tremor of the upper limbs;
- vomiting.
The clinical picture of edematous forms of pathological conditions:
- apathy and depression;
- drowsiness;
- impossibility to navigate in space;
- pale skin;
- swelling of the eyelids and fingers;
- decrease in heart rate;
- a steady increase in systolic and diastolic blood pressure.
Convulsive form is manifested by the following features:
- muscle twitching;
- impaired consciousness;
- fainting;
- disorientation in space.
Cramping form in which there is a disturbance of brain arteriolar tone, is the heaviest view crisis, can lead to coma and cause death.
Among women
In females in the presence of obesity is observed mainly edematous form of crisis with the development of the particular clinical picture. Symptoms in women manifested by the sudden appearance of the internal tide, the rapid rise in blood pressure, pale skin, frequent urination. There is excessive drowsiness, lethargy and fatigue. This condition lasts for several hours to 2-3 days.
men
Features hypertensive attack in men that it rarely occurs, but is less well tolerated and often leads to severe consequences, such as a heart attack. Symptoms in men (in addition to general manifestations), which lasts for 1-2 days - spasmodic contraction of the muscles, feeling an acute shortage of air, severe shortness of breath, psychological disorders, manifested in a strong fear for their a life.
Diagnostics
Definition of hypertensive crisis is based on the deviation of the blood pressure of the individual performance standards, analysis of existing clinical manifestations and patient complaints. To make a diagnosis requires a comprehensive examination, including:
- pressure measurement indicators (conducted every 15 minutes);
- blood analysis and biochemical;
- urine analysis;
- an electrocardiogram;
- Renal ultrasonography;
- echocardiography;
- chest X-ray;
- ophthalmoscopy.
To determine the cause of the attack is consulted a therapist, a cardiologist and a neurologist. If there is such a feature, as reduced visual acuity, need advice of an ophthalmologist.
What to do for an emergency
To combat hypertension and edema crisis needs urgent medical care. The first thing to do around people - call medical team. While emergency aid does not arrive, it is important to pre-hospital care was provided.
First aid for hypertensive crisis is of great importance. In many cases, the provision of first aid to a person in a fit not only helps to stop intense symptoms, but also save lives by warning dangerous consequences, including heart attack and stroke. The algorithm first aid:
- The victim must be put in a semi-sitting position at the back need to put a pillow or other object such as a twisted roll clothes.
- If possible, calf impose on mustard, can be dipped human hands and feet into the water, whose temperature does not exceed + 40 ° C.
- Providing first aid, measure pressure, indicators and time when the measurements were carried out, you want to record.
- Loosen man clothing on the chest, open the windows in the room to let in fresh air.
- To assist the need to take measures that will help to normalize the human breath to ask the victim to make a few slow breaths (up to 10 times). Nothing else should be done after the breath managed to normalize. The best thing to the arrival of doctors leave the person in a sitting position.
Relief of panic - a mandatory step pre-hospital care for hypertensive attack, because people due chest pain and lack of air will be in emotional stress and fear for their a life. Completely remove a hypertensive crisis, these measures can not, but they will improve the condition of the victim and help to prevent the consequences.
Medications that are constantly taking people with hypertensive disease, should not be given because they have a cumulative effect and will not help to arrest the crisis. With the development (in the background of a crisis) violations of the heart muscle, for example, angina pectoris, manifested by painful sensations in the chest, the victim may be given nitroglycerin (1 tablet put under the tongue).
To fix an intense headache to the back, you can apply ice or another cold object. It is strictly forbidden to give the victim anything to eat or drink, because it will provoke vomiting.
How to treat
With the development of hypertensive crisis of human need as much as possible to deliver a medical facility quickly, where experts will carry out the appropriate therapy. Therapy complex attack, including the observance of complete rest, carrying out medical policy aimed at the normalization of blood pressure. Symptomatic treatment of complicated crisis for the relief of symptoms of the disease and the effects of prevention.
To get rid of the pathological state of use of the following drugs:
- ACE inhibitors. Captopril normalizes blood pressure indicators, helps to reduce the degree of resistance to blood vessels, increasing their wall, due to which the pressure can not recover.
- Calcium channel blockers. Corinfar exerts pressure lowering action.
- Alpha-adrenergic agonists. Clonidine has a hypotensive effect, reduces the frequency of contractions of the heart muscle, affects the nervous system sedative manner.
- Nitrates. Nitroglycerine expanding the lumen of vessel walls contributes to the normalization of metabolic processes.
- Diuretics. Furosemide has a pronounced diuretic effect, suppresses edema, displays the body of sodium and chlorine.
- Neuroleptics. Chlorpromazine is used in the event that other drugs can not lower the pressure.
- Sedatives. Magnesium sulfate reduces component AD has on the smooth muscles of blood vessels relaxing effect, contributes to the amplification process diuresis.
Treat attack need only complex, so a patient is prescribed several drugs from different therapeutic groups. Preference is given to tablets which dissolve. If the case of an emergency, crisis with a complicated course, the patient's condition is deteriorating rapidly, there are risks of harmful effects, the drug is administered intravenously or intramuscularly.
Symptomatic therapy includes receiving the following means:
- soothing;
- antiemetic;
- anesthetics;
- anticonvulsants;
- cardiac glycosides.
Also carried oxygen treatment. The duration of its individual, depends on the severity and intensity of the symptoms and consequences of risks.
How to recover
The therapy does not end after removal of attack in the hospital inpatient. Recovering from such a state for a long period, it requires compliance with a number of recommendations.
Rehabilitation after attack comprises receiving anxiolytic and antihypertensive agents. It is recommended to undergo a course of hirudotherapy, conduct regular foot bath with hot water, apply a heating pad or mustard to the lower extremities.
To avoid general condition worsened after the crisis never happened relapse, all patients need to observe dietary intake. Foods that should be excluded from the diet completely:
- chocolate and confectionery;
- coffee and strong tea;
- alcoholic, carbonated beverages;
- spicy foods, spices, seasonings, large amounts of salt;
- pickles;
- smoked sausages;
- garlic;
- muffins, pastries, fresh bakery products;
- fatty fish and meat varieties.
The basis of the diet - whole grains, lean meat and fish, fresh vegetables and fruits, berries, milk and milk products the minimum percentage of fat.
Along with dieting is recommended to take vitamin and mineral supplements. Among the mineral elements are particularly important calcium, magnesium and potassium. Of preference should be given vitamins such vitamin groups A, B, C, E and F, they restore the tone and elasticity of the vascular walls.
During the rehabilitation period is allowed to use the recipes of traditional medicine, but they will act only if when the patient will comply with the diet, take prescribed medications and comply with the physical and emotional rest. Recommended methods of traditional medicine:
- Valerian (can substitute motherwort). 1 tablespoon pour 200 ml of a boiling water, leaving it stand for 20 minutes, filter. Take 40 ml 3 times per day.
- Chokeberry. Daily use of 100 ml compote based on this berries. This will help normalize blood pressure and prevent a recurrence of a crisis.
- If a man felt that he again began to rise pressure, it is possible to attach heels cloth or gauze soaked in apple cider vinegar, to keep a compress takes 15 minutes.
It is forbidden to replace medicines recipes of traditional medicine. Broths and lotions can not independently resolve a hypertensive attack and prevent its recurrence. They only contribute to some relief of symptoms of hypertension and help to enhance the therapeutic effects of drugs.
During the rehabilitation period is necessary to observe preventive measures that will help to recover faster and prevent relapse. It is important to follow a diet and to prevent weight gain. It is forbidden to engage in heavy physical labor, sports. It is necessary to abandon this bad habit, like smoking. Drinking alcohol is also prohibited.
If you find that antihypertensive medications spectrum stopped giving positive therapeutic effect, it is necessary to consult a doctor, who will adjust their dosage or substitute for more effective analog.
Every day it is necessary to measure blood pressure, and performance record in a diary. The man who at least 1 time suffered a crisis, should 2 times a year, be sure to pass preventive examination by a physician and cardiologist.
How dangerous
The consequences of a hypertensive crisis in women and men is almost always. Attack suddenly elevated to critical pressure marks a negative impact on the status and functioning of the central nervous system. There is often a complication on the part of the kidneys and other organs of the urinary system.
Without the provision of timely medical assistance complicated hypertensive attack can lead to heart attack, stroke and death of a person.
Frequent complications that occur after suffering a crisis:
- encephalopathy in an acute or chronic course;
- heart attack;
- stroke;
- renal failure;
- deviations in the work of the heart muscle, until the emergence of heart failure;
- brain edema;
- pulmonary edema;
- appearance of thrombus in blood vessels (thromboembolism);
- aortoclasia or layering of its walls (aortic rupture in 90% of cases becomes a cause of death);
- paresis;
- complete or partial paralysis after complicated type crisis.
A high risk of death if during the first days after the attack occurred the person does not meet the medical assistance.
Due to impaired blood circulation in the brain there is a deterioration of mental activity, reduced memory. Disturbed state of visual organs due to damage to the retina.
After suffering a crisis may disrupt the psycho-emotional state of a person. This is caused by a strong fear for their lives during an intense manifestation of the symptoms. Often the patient, when his condition stabilized, is under stress, which threatens the development of depression. In this case, you need to consult a psychologist and psychotherapist.
The development of the negative effects typical of the complicated type of attack. When uncomplicated pathology work and the state of internal organs is not disturbed, a person recovers quickly, the risk of recurrence in compliance with all medical recommendations minimal.
