Hypertensive crisis is the sudden increase in arterial blood pressure which is followed by complaints and pathological changes from a brain and a cardiovascular system against the background of vegetative disturbances.
Hypertensive crisis can develop at any degree of arterial hypertension or in symptomatic arterial hypertension. Hypertensive crisis can sometimes arise also at the healthy person.
The Krizovy state is usually provoked:
Symptoms of hypertensive crisis:
- psychoemotional overloads
- weather changing
- abuse of coffee, alcoholic beverages
- hormonal disturbances
- cancellation of earlier taken hypotensive drugs
- brain diseases (stroke), hearts (myocardial infarction, stenocardia attack), kidneys.
Hypertensive crises subdivide on:
- the sudden beginning within several minutes or 1-3 hours
- level of arterial blood pressure individually high (at one patient it is level 240/120, at another - 130/90). It depends on the initial level of arterial blood pressure. If the patient has constantly low level of pressure, even its small increase can cause hypertensive crisis
- availability of complaints from heart (a heartache, heartbeat)
- availability of complaints from a brain (headaches, dizzinesses, various disorders of vision)
- availability of complaints from the autonomic nervous system (fever, a shiver, perspiration, feeling of rush of blood to the head, feeling of shortage of air, etc.).
On classification of foreign authors all crises are divided into complicated and uncomplicated:
- hypertensive crisis with prevalence of a neurovegetative syndrome. Usually such crisis begins quickly, arises after a stress, psychoemotional loading. The patient has complaints to the pulsing headache, dizziness, nausea, more rare there is vomiting. This state is followed by sensation of fear and feeling of shortage of air. The patient can be excited, he has a shiver in hands, a fever, perspiration. Such state lasts not for long from 1 to 5 hours. Often after crisis there is a plentiful urination. Usually such crisis of threat for life does not represent.
- water-salt hypertensive crisis. It is caused system renin-angiotensin-aldosteronovoy. It is that system which normal maintains constancy of internal environment of a human body, in this case arterial blood pressure. There are complaints to a severe headache, constant character, nausea and vomiting. Patients are often sluggish, they are sometimes disoriented in space and time. Can forget what day today, get lost in the familiar area. Various disorders of vision - doubling in eyes,<мушки> and spots before eyes, loss of sites of sight are possible, hearing can worsen. Such state can proceed up to several days.
- acute hypertensive encephalopathy. This serious condition caused by substantial increase of arterial blood pressure. Happens because of disturbance at supertension of normal blood supply of a brain. At this state the confusion of consciousness, a spasm, passing disturbances of the speech is possible.
Treatment of hypertensive (hypertensive) crisis:
- Uncomplicated crises - without defeat<органов-мишеней>. Such crisis nevertheless poses a threat for the patient's life. Arterial blood pressure needs to be reduced within several hours.
- The complicated crises - with defeat<органов-мишеней>. Target organs it is those bodies which to a greater or lesser extent suffer in this disease. In arterial hypertension this heart, a brain, vessels, kidneys. Such crises pose hazard to life of the patient and demand a lowering of arterial pressure, immediate within 1 hour. At a long course of such crisis there can be complications from heart (myocardial infarction, acute insufficiency of a left ventricle, unstable stenocardia, arrhythmias), vessels (the stratifying aortic aneurysm, bleedings), a brain (stroke, the tranzitorny ischemic attack, acute hypertensive encephalopathy), kidneys (acute renal failure).
In uncomplicated crises the reception of 1-2 tablets of captopril, nifedipine, a katapressan under language usually helps. If it does not help, enter intravenously Dibazolum, Obsidanum, clonidine, Sodium nitroprussidum, nimodipin, furosemide. All complicated crises have to be hospitalized. For prevention of crises it is necessary to treat constantly arterial hypertension, to find out conditions and the causes of krizovy states and to avoid them.