Now, many people are faced with the problem of high blood pressure. And in some cases, such a violation leads to the development of hypertension. The disease itself, proceeding in the chronic stage, does not pose a danger to human life, although it is a risk factor for more serious complications associated primarily with the cardiovascular system.
However, there is a period of exacerbation of the chronic form, which in medicine is called hypertensive crisis. Symptoms of this condition indicate circulatory failure.
Status Description
Hypertensive crisis - ICD-10 code - a very dangerous phenomenon associated with increased pressure. Occasionally, its increase can sometimes occur in completely healthy people, in particular, with severe stress or physical exertion. In addition to sustained high blood pressure, the crisis has a number of other symptoms that indicate insufficient blood circulation.
This is a fairly prolonged condition, lasting for several hours or even days. Basically, a crisis does not pass on its own without treatment, and if it does, it does very serious harm to the body.
It is worth remembering that many consider hypertension a symptom of hypertension, but this is completely not the case, because a similar condition can develop against the background of normal pressure. It all depends on the characteristics of the patient’s health and well-being, as well as the degree of development of the disease.
Classification of crises
Based on the features of increasing pressure during a hypertensive crisis, complications and symptoms, experts divide this condition into three types, namely:
- hyperkinetic;
- hypokinetic;
- eukinetic.
The hyperkinetic species is characterized by a significant increase in cardiac activity with stable or reduced vascular resistance. Its development takes place during the initial stages of hypertension, most often this happens rapidly and without a noticeable deterioration in well-being. Headache, nausea, and sometimes vomiting can occur abruptly. With subsequent development, symptoms of a hypertensive crisis are expressed in the occurrence of nervousness, heat, increased sweating, as well as a violation of the heart rhythm.
It happens that red spots form on the skin, the skin is wet to the touch, the pulse quickens, which is often accompanied by an increased heartbeat and the occurrence of severe pain in the sternum. All changes associated with the activity of the heart are detected on the cardiogram. No acute complications were observed.
The hypokinetic type occurs with a decrease in cardiac activity, as well as a sharp increase in vascular resistance. It is observed in patients with a prolonged course of hypertension. Such a condition develops very slowly, and at the same time, a decrease in hearing and visual acuity is possible. The pulse often does not change, but in some cases a decrease in its frequency is possible. The likelihood of ischemic stroke is very high.
The eukinetic type is characterized by the fact that the cardiac output is normal, but the resistance of the vessels increases. This condition occurs as a result of a sharp jump in pressure in people suffering from advanced forms of hypertension.
The lesions that arise as a result of the course of crises are divided into complicated and uncomplicated. Hypertensive crisis of uncomplicated type often develops rapidly, but it does not have a long course and is easily eliminated by the use of antihypertensive drugs. However, even in the absence of complications, the pathology can be very dangerous for a person's life, and therefore the doctor can prescribe an operation.
Complicated types of hypertensive crises are mainly characteristic of the advanced stage of hypertension. Often there are various kinds of disorders in the vascular region, the most common of which is vascular encephalopathy. She is very dangerous for her complications, in particular, such as a stroke and a drop in intelligence. In some cases, a heart attack, stroke, impaired heart function, acute renal or heart failure, angina pectoris, and edema of the internal organs are possible.
Causes of occurrence
Hypertensive crisis (ICD-10 code) is characterized by a prolonged, persistent increase in pressure. The main cause of this condition is hypertension. However, a violation can be observed with secondary hypertension that occurs with other diseases, in particular, such as:
- kidney disease
- ischemia;
- head injuries;
- hyperthyroidism;
- hormonal imbalance;
- stroke;
- diabetes;
- atherosclerosis;
- nephropathy of pregnant women;
- systemic lupus erythematosus.
In addition, there are certain predisposing factors that contribute to the development of hypertensive crises, in particular:
- sedentary lifestyle;
- excess weight;
- abuse of caffeinated drinks;
- BPH;
- menopause period;
- osteochondrosis;
- stress and depression;
- vegetovascular dystonia;
- change in weather conditions;
- non-compliance with antihypertensive drugs;
- lack of sleep and rest.
Particularly noteworthy are bad habits, in particular tobacco smoking and alcohol abuse. Doctors note that drinkers often suffer from hypertensive seizures.
Main symptoms
Symptoms of a hypertensive crisis may vary slightly, depending on what type of disorder is observed. The main signs, in addition to a critical increase in pressure, are considered such as:
- Dizziness
- headache;
- noise in ears;
- pain in the area of the heart muscle stitching type;
- weakness;
- heart rhythm disturbance;
- dyspnea;
- temperature rise;
- feeling of anxiety and fear;
- increased sweating;
- visual impairment.
Among the manifestations of a hypertensive crisis, one can distinguish a headache, which is significantly aggravated by sneezing or even the slightest head movement. Often it is accompanied by pain in the eye area. During the course of crises, blood counts can significantly change, in particular, such as an increase in the number of leukocytes, ESR, and protein levels in the urine.
Sometimes nausea, vomiting, convulsions, blurred consciousness may occur. At the first stage of a hypertensive crisis, there may be redness of the skin. Dizziness is mainly caused by spasm of the carotid or vertebral artery. It may additionally be accompanied by a loss of orientation in space.
First aid
It is important to take urgent action in case of hypertensive crisis, since such a condition can be very dangerous and threaten the life of the patient. Treatment should be started before the doctor arrives. Be sure to comply with bed rest. The patient must be laid so that the patient is in a half-sitting position. Need to limit drinking.
With an uncomplicated type of hypertensive crisis, it is recommended to take 25 mg of Captopril or 10 mg of Nifedipine under the tongue, and after 30 minutes, re-measure the pressure. In the absence of effect, you need to take another pill.
In the presence of tachycardia, 25 mg of Metoprolol should be taken, and after 30 minutes, blood pressure should be monitored. In the absence of the required effect, you need to take another pill under the tongue. In the case of severe pain in the heart, it is recommended to take the Nitroglycerin tablet under the tongue. Additionally, you can take sedatives, in particular, such as valerian, motherwort, validol.
Diagnostics
There is a certain standard of care for hypertensive crisis, however, treatment should be carried out only after diagnosis. Previously, the doctor makes a diagnosis based on the patient's complaints and measuring blood pressure. In this case, one must take into account what pressure the patient had without exacerbation. For diagnosis, apply such techniques as:
- pressure measurement;
- urinalysis to evaluate kidney function;
- electrocardiography;
- blood chemistry;
- ophthalmoscopy;
- echocardiography;
- chest x-ray.
Additional research methods are prescribed only as needed, depending on the developing complications.
Treatment feature
To stop the hypertensive crisis, the medications prescribed by the doctor are used with a gradual increase in the dosage of the drugs. With a sharp decrease in pressure, vascular ischemia can occur, as well as a heart attack. Normal is a decrease in pressure of not more than 20% in the first 2 hours. With a complicated course of the violation, doctors recommend carrying out drug treatment for a long time.
Uncomplicated forms are eliminated quite simply with the help of the Kapoten preparation. Treatment of the eukinetic type is not always carried out with the help of tablets. Strong pain and sudden pressure surges can be eliminated only by injection of special strong drugs. If the treatment does not lead to a positive result, then the patient is usually sent to a hospital.
If the hypertensive crisis in an adult is complicated, then the person is immediately hospitalized in a hospital. The choice of medications largely depends on the general well-being and existing symptoms. It is important to remember that after the crisis is over, you must always monitor your well-being. Hypertensive crisis in men and women in any case indicates that the condition of the vessels is not very good.
After normalizing the condition, you must:
- examination;
- adherence to drug treatment;
- daily pressure control;
- change in diet;
- limiting stressful situations.
If signs of a recurrence of crises are identified, be sure to consult a doctor immediately. Do not self-medicate, as this can be very dangerous to health.
Drug therapy
Hypertensive crisis in the elderly occurs very sharply, against the background of seeming good health. This mainly happens after a person independently decides to stop taking antihypertensive drugs prescribed by a doctor. When a crisis occurs, you must immediately call an ambulance. The victim and loved ones need to remain completely calm and take appropriate measures.
For self-management of a hypertensive crisis, the patient needs to be given the drug that he is taking. If he has a headache, then he should give a tablet of a diuretic drug. If the existing symptoms appear in the form of pain in the heart, you need to take "Nitroglycerin."
Significantly lowers the pressure of the drug “Clonidine”. It is used if the pathological process is accompanied by tachyarrhythmia. The drug is administered intravenously or intramuscularly. In order to eliminate cerebral symptoms and reduce blood pressure during a hypertensive crisis, the drug “Droperidol” is prescribed. It helps to normalize the well-being of the patient. In addition to antihypertensive drugs, medications are prescribed to the patient that help eliminate signs of concomitant pathologies.
Folk techniques
In addition to medications, doctors recommend the use of folk remedies to eliminate signs of a hypertensive crisis. They can be divided into phytotherapeutic and reflexotherapy effects.
A compress of vinegar or apples, which must be applied to the heels, has a good effect. They have a therapeutic effect very quickly, so you need to constantly monitor the pressure. For treatment, you can also use special teas prepared on the basis of medicinal herbs. Fruits, vegetables and berries, which can be consumed as a medicine and as a prophylactic, have a healing effect. Freshly squeezed beet juice helps to lower the pressure, however, when it is consumed, you need to constantly monitor the pressure level to prevent its critical decline.
A good remedy is a decoction of berries and leaves of lingonberry. They have a diuretic effect, which favorably affects the body. Typically, such herbal medicine is carried out continuously or used as a course of treatment. Good pressure stabilizers are decoctions of pomegranate peels and honeysuckle berries.
Possible complications
How long the hypertensive crisis lasts depends largely on the patient's body, as well as on the characteristics of the course of the disorder. Without appropriate treatment, it can cause serious harm to health. High blood pressure has a negative effect on all human organs. The most vulnerable organs are the kidneys and liver. Among the main complications, the following should be highlighted:
- encephalopathy;
- heart attack;
- decreased intelligence;
- stroke;
- paralysis;
- impaired liver function;
- visual impairment;
- cardiovascular and renal failure;
- pulmonary and brain edema;
- thromboembolism;
- aortic aneurysm.
Relatively mild consequences include constant dizziness and headaches. It is worth remembering that with a severe course of a hypertensive crisis, if the patient is not provided with timely help, there is a high risk of death.
Prophylaxis
In order to prevent the occurrence of a hypertensive crisis, it is necessary to control blood pressure, as well as take medications prescribed by a doctor. In addition, the main preventive measures include:
- dieting;
- rejection of bad habits;
- playing sports;
- preventive examinations;
- treatment of diseases in which arterial hypertension develops.
It is very important to limit salt intake and drink enough fluids per day.