Hypertensive crisis (GC) is a phenomenon so widespread that, perhaps, you will not find people in your megalopolis after forty who have not experienced all the charms of this unexpected and sad surprise.
He does not particularly warn about his appearance and can catch a patient anywhere – in a minibus, at work, at a picnic, in a cafe. The prerequisites for HA are usually stresses from which the nervous system of a particular person is not able to adequately exit. Her reaction also explains the development of vascular failure in the face of emotional overload.
Inconsistent work of the autonomic nervous system (ANS) divisions forms a specific type of HA. On these principles, their classification is built.
Hazardous Risk Factors
GC treatment determines its type, as it should directionally affect the cause of the crisis. Its appearance is promoted by changes in the central humoral and local (region of the kidneys) mechanisms, due to the loss of the ability to adapt to stresses, in which a special role is assigned to the behavior of blood vessels.
What is the difference between hypertension and hypertension read here.
Risk factors that provoke the development of HA can be:
- Violations of the nervous system – situational neurosis and similar conditions;
- Mental overload, regular stressful situations;
- Hereditary addiction;
- Endocrine problems;
- Hormone imbalance (PMS (premenstrual syndrome), menopause);
- Accumulation of water and salt in organs due to excessive consumption of food dangerous for hypertension;
- Smoking and drinking alcohol in any form and dose;
- Excessive stress (emotional, physical, overstrain of hearing or vision, strong vibration);
- Geomagnetic storms and a sharp change in weather that does not allow the body to quickly rebuild;
- Exacerbation of concomitant chronic diseases;
- Renal failure;
- Unauthorized withdrawal or periodic use of prescribed antihypertensive drugs;
- Osteochondrosis of the cervical vertebrae.
Any of the above reasons is enough to provoke HA. Depending on which part of the ANS will be involved in the first place, 2 types of disease are distinguished. Hypertensive crisis symptoms will have, depending on its variety.
The main signs of the disease
Hyperkinetic type occurs with a high tone of the sympathetic division of the ANS. It most often occurs at a young age, preferably in men. It develops instantly and is characterized by such signs:
- A serious increase in blood pressure;
- General overexcitation;
- Increased sweat secretion;
- A pain in the head of a pulsating nature;
- Pain in the heart with the feeling that it stops periodically;
- Hand tremor;
- Dry mouth, a rush of blood to the face;
- After stopping GK – frequent urge to go to the toilet with a large volume of flu >
HA of the first type (it is also called cardiac, systolic) occurs with an increase in blood ejection in the heart and an increase in its contractions, while the resistance of blood vessels and blood volume remain the same. This manifests itself in the form of increased pressure (pulse, heart). The consequences of heart-type HA can end:
- Hemorrhage or cerebral edema;
- Myocardial infarction;
- Impaired renal function;
- Eye damage.
The hypokinetic type develops imperceptibly, gradually, but confidently. It catches up with women who gained excess weight during menopause due to hormonal disruptions. GK of the second type sends hints of its appearance in a few days. Symptoms of a hypertensive crisis of the second type:
- Sleepy state, apathy.
- Disability and mood decline.
- Dizziness and weakness.
- Pain in the head bursting in nature, when there is a desire to pull the head with a towel.
- Nausea and vomiting do not relieve all signs of malaise.
- Reduction in urine, manifested by swelling of the face, arms, legs.
- Decreased visual acuity, darkening in the eyes.
- The skin is dry and pale.
The second type (its other name is edematous) controls the parasympathetic part of the ANS. It is characterized by a decrease in the frequency of contractions of the heart and the ejection of blood with a simultaneous increase in its volume and peripheral resistance. Symptoms of GC by the edematous type indicate its diastolic origin. In the formation of acute left ventricular failure, we can talk about the complications of HA.
Complications with GC
Complicated (convulsive, cerebral) crises are treated in neurology. HA in the form of a disorder of coronary and cerebral blood flow, accompanied by seizures, can develop with equal probability from any type of HA. An individual approach in this case is necessary not only with primary care, but also in the subsequent treatment of HC, since a convulsive crisis can be aggravated by such serious diseases as:
- Myocardial infarction;
- Pulmonary or brain edema;
- Renal pathology.
They diagnose the condition on the basis of anamnesis, age characteristics, clinical indicators and compare with symptom hypertension, characterized by:
Glomerulonephritis (k >
Complications of HA in the form of impaired cerebral blood flow and its consequences quickly lead to death. According to medical statistics, about half of patients with this diagnosis die within 3 years with kidney problems or a stroke. In 83% of patients, damage to the first target organ was recorded, in 1% to 14, approximately 2% have multiple organ failure.
Symptoms of GC
After identifying the nature of the HA, the patient will be prescribed treatment in accordance with his type of disease. But most often, vascular problems of this kind happen unexpectedly when a person does not even have an idea about the problem. To quickly navigate, it is important to distinguish between the symptoms of HA:
- Sudden changes in blood pressure;
- Acute pain in the occiput and parietal region;
- Lack of coordination, dizziness, flickering of “flies” in the eyes;
- Heart pain, tachycardia;
- Fainting and breakdown;
- Oxygen deficiency, shortness of breath;
- Bleeding from the nose;
- Nausea and vomiting that do not relieve all other symptoms;
- Drowsiness and impaired consciousness;
- Psychomotor overexcitation.
Hypertensive crisis symptoms and first aid are standard, not related to its type.
Hypertensive crisis: emergency care (algorithm)
Emergency care for hypertensive crisis is therefore called the emergency medical care, because only immediate and clear actions of others can prevent serious complications.
- Immediately call a doctor or ambulance (it is better if someone else does this, and not the patient himself).
- Using pillows to create a comfortable position for the victim – reclining.
- Unfasten the collar and other clothes that make breathing difficult, as the patient does not have enough air during a crisis.
- Ventilate the room, after covering the patient with a blanket, so as not to cool.
- Attach a heating pad to your feet (a plastic bottle with hot water is also suitable). You can put mustard plasters on your calves.
- If the affected person is hypertensive, give him the drug that he usually takes.
- Corvalol (20 drops) will help relieve stress. Usually an attack is accompanied by a panic fear of death.
- Captopril can be placed under the tongue and asked to dissolve the tablet.
- If the patient complains of a bursting headache, a sign of high pressure, a furosemide tablet will help.
- If nitroglycerin is at hand, you can put the victim under the tongue. It is important to remember that the drug dramatically lowers blood pressure, this condition is accompanied by increasing headaches. In order to neutralize the negative side effect of nitroglycerin, it is sometimes taken in parallel with validol.
Emergency care for hypertensive crisis, the algorithm of action should be clear and consistent.
First aid for hypertensive crisis
The listed measures aimed at reducing blood pressure are pre-medical care. It is necessary to help the patient in the first stage, before the arrival of the ambulance. But replacing medical care with such methods is impossible. With a hypertensive crisis, first aid should be based on the main commandment of medicine “do no harm!” First of all, this is related to the choice of drugs, since not all medicines that are used to stop the hypertensive crisis are completely safe.
For example, ACE inhibitors such as captopril or enalapril can cause angio-neurotic edema. Outwardly, the reaction resembles an allergy, but its consequences are much more dangerous and insufficiently controlled.
You should not abuse the very popular nitroglycerin: if blood pressure is not critical, then with a sharp decrease, the drug can provoke a collapse. The vasodilating effect of this drug is suitable for cardiovascular problems, therefore, it is necessary to apply it for myocardial infarction. Before offering the patient a medicine, it is necessary to calmly assess the situation and make the right decision.
Adequate first aid for hypertensive crisis is of particular importance, the algorithm of action of which involves constant monitoring of pressure every 12 hours. For an accurate assessment of blood pressure, it is necessary to measure it on both hands, the cuff must be precisely sized. For comparative analysis, the pulse is checked on both the arms and legs.
With independent pressure control, readings of 180/110 mm RT. Art. talk about an impending hypertensive crisis, if the parameters are repeated after a few minutes with repeated measurement.
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First aid for hypertensive crisis at home
The emergency team should deal with the relief of hypertensive crisis with constant monitoring of blood pressure. But it is not always possible to quickly use its services. It’s good if a health worker (at least a nurse) lives in the neighborhood, and in the home medicine cabinet there are disposable syringes and injectable drugs that can stop the attack at home.
Such tactics helps a lot of hypertensive patients who have been ill for a long time and always have in stock medications that can stop the attack on their own, “so as not to disturb the doctors again.” Over time, they themselves already acquire a certain competence, so the provision of emergency care for hypertensive crisis may be limited to the administration of an intramuscular complex of drugs:
- Furosemide (do not forget that it is able to remove calcium, potassium and other trace elements, therefore, its regular use involves the simultaneous administration of panangin);
- Dibazole (at extremely high blood pressure, it is dangerous, since it tends to increase pressure before it starts to lower it slowly);
- Sulfuric Magnesia – intravenous injection gives a positive effect, but it must be done with extreme caution or entrust this procedure to the doctor;
- Antispasmodics such as no-shpa, papaverine;
- Vitamin B6.