An ischemic crisis is a condition in which the circulation of blood in the region of the brain and heart muscle is impaired. This is one of the options for cerebral hypertensive crisis. The basis of this condition is hypertonic pathology, or arterial hypertension. At risk are people in whom high blood pressure does not cause discomfort. A crisis may occur already when blood pressure rises to 140/100.
Doctors still cannot clearly answer why a crisis occurs, since such a violation has not yet been fully studied.
How to understand that an attack has begun?
Symptoms of ischemic crisis are quite diverse and non-specific. In some cases, they are considered as failures in the emotional state of a person. At the initial stage, as a rule, there is an increased excitability of the nervous system and increased energy, which was not previously observed.
In other patients, on the contrary, increased irritability, even aggressiveness, is observed, they can cry for no reason. Some people notice that tachycardia has begun, excessive sweating appears and tormented by a sense of fear. Vomiting may begin following nausea.
In the future, the symptoms of the ischemic crisis completely depend on where the area and the vastness of the affected area are affected. There may be "flies" in front of the eyes, a feeling of pressure in the eyeballs and other visual impairment. Some patients have an unsteady gait, they feel disoriented. Other patients suffer from a violation of facial symmetry, or problems with articulation of the speech apparatus appear.
However, not all patients have open symptoms, it can be expressed only in weakly noticeable psychoemotional disorders, which only close people can notice.
Why is this happening?
The development of ischemic hypertensive crisis is associated with circulatory disorders. This condition is characteristic of stressful situations. It can also occur in individuals who are very sensitive to changes in the weather or to hypothermia, overheating. There are other reasons: food stress, physical stress, etc.
Even a large amount of alcoholic beverages can cause a crisis, overheating of the body or severe overwork. Persons who are too fond of salty foods may suffer from a crisis. Long-term use of a number of pharmaceuticals can cause an attack. Moreover, such attacks are quite difficult to stop.
And naturally, hypertensive patients who take antihypertensive drugs inopportune are at risk. Crisis is common in women during menopause.
How does this happen?
An ischemic crisis always occurs suddenly. As a result of stress or another load, arteriol tone increases or cardiac output increases, and as a result, there is a rapid increase in blood pressure. And this is the strongest load on the regional blood flow and heart muscle.
Who is at risk?
In addition to hypertension, an ischemic attack can occur in individuals with the following pathologies or problems:
- if a person takes hormonal drugs;
- alcohol lovers;
- with obesity;
- if the diagnosis of prostate adenoma is present;
- with kidney problems;
- if there is a genetic predisposition.
At risk are people with impaired circulation or cardiac muscle function (cardiac asthma or coronary syndrome, coronary artery disease).
Could there be an attack in childhood?
Unfortunately, admittedly, an ischemic crisis can also occur in children. The reasons for this condition are the same as in the case of adults. If the baby has kidney failure, brain injuries or intracranial hypertension, then it is possible that an attack will occur. At risk are also children who have suffered hypertension of the second type.
Possible complications
The condition of a person who has an ischemic crisis is characterized as very serious. Therefore, it is very important to diagnose the problem in time and take all measures that will stop the attack. In cases where an incorrect diagnosis was made or first aid was not provided, the following complications may occur:
- thrombosis;
- azotemia;
- pulmonary edema;
- renal failure;
- embolism of the arteries.
If the heart muscle is damaged as a result of the attack, then arrhythmia or tachycardia may develop.
How is the diagnosis made?
It is clear that at the very beginning of an attack it is necessary to take all measures that will reduce the manifestations of the crisis. Moreover, if everything happened on the street or at home, where it is impossible to accurately understand what is happening to the person.
If the crisis occurred in the hospital, then with the simultaneous measurement and decrease in blood pressure, complaints are clarified. The doctor assesses the general condition of the patient, checks tendon reflexes, performs auscultation of the heart muscle and lungs. Brain MRI, electrocardiography, and ultrasound diagnostics of blood vessels can be performed.
After stopping the seizure, the patient must be sent to specialized specialists: an ophthalmologist and a neurologist, so that they evaluate the health status of individual organs.
Prognosis for recovery
An ischemic crisis against a background of high pressure can cause death. If all measures to stop the attack are taken in time, then the probability of positive results from drug therapy is very high.
An unfavorable prognosis may be in the following cases:
- late diagnosis;
- it is very likely that after an attack there will be complications that are life-threatening.
First aid
If a person became ill, then he needs to ensure a half-sitting position. Pillows can be placed under the head. Further, the urgent help of the ischemic crisis is that the patient should be given drugs that reduce high blood pressure. If the patient previously took any drugs, they helped him, then it is precisely them that must be given, but at the dosage recommended by the doctor. In particular, it can be Corinfar or Kapoten. To normalize the functioning of the nervous system, you can give "Valocordin" or "Corvalol".
Naturally, if it is not possible to reduce the pressure in any way, then it is immediately necessary to call an ambulance crew.
What if no one is around?
A person who felt that he had begun a blow should immediately lie down, try to relax. It is necessary to take a few breaths and exhalations, take a pill for high blood pressure.
Treatment of ischemic crisis can be carried out with drugs that are used on an ongoing basis, also Captopril, Claforan and others are often used. If the medicines did not help and the pressure does not decrease for 30 minutes, then immediately dial the phone number 03.
In cases where it was possible to stabilize the state, do not relax, you must visit a doctor and tell about the incident. You may need to adjust the dosage of the drug you are taking or replace it with another. One should never forget that hypertensive patients need to regularly measure their pressure in order to prevent a stroke in time.
Therapeutic measures
The pharmaceutical market has a fairly wide range of drugs. Ischemic crisis is a fairly common phenomenon, therefore, how to stop it, not only emergency doctors know, but also clinicians. It is advisable to know the basics of first aid for the patient himself and his relatives.
"Clonidine"
This is a classic treatment for crisis. This is a very powerful tool for lowering blood pressure, so you can use it with very great care. It is the drugs containing clonidine that so quickly reduce the pressure that they can cause collapse. In light of this, drugs of this group are used only in a hospital when the patient is in a horizontal position. There are two forms of release: a solution for intravenous administration and tablets under the tongue.
Beta blockers
Means from this group are designed to expand the lumen of the arteries, slow down the heartbeat. An action of this type occurs due to blocking adrenergic receptors on the walls of arteries and heart muscle.
Of this group, the most popular are: Inderal, Metoprolol, Labetalol, Anaprilin.
Calcium blocker blockers
Drugs from this group are widely used in therapy aimed at eliminating cardiac arrhythmias and lowering blood pressure. Let's consider one of them in more detail.
"Nifedipine": instructions for use, at what pressure should I take it?
This drug has been known since the days of the Soviet Union, and its popularity has not diminished over the years. The drug allows you to slow down the rate of passage of calcium ions to the vessels of the heart. As a result, the lumen in the vessels increases and blood pressure decreases. In addition, the drug normalizes heart rate and reduces the load on the heart.
However, the longer the drug is taken, the less effective it is, as indicated in the instructions for use of Nifedipine. At what pressure should I take it? The drug is indicated for use in cases where pressure increases the rate by at least 20-25%. Already at this level almost immediately, after 5-30 minutes, the effect of taking it is manifested.
This medicine has contraindications. It is forbidden to use if tachycardia is present, had a heart attack 8 days ago, decompensated heart failure is present. It is forbidden to use the medicine during pregnancy and lactation.
During the attack, depending on the severity of the symptoms, 0.25 to 10 mg per kilogram of patient weight is prescribed.
ACE inhibitors
Drugs of this group are most often used to treat hypertension, but can also be used to relieve a crisis. Such tablets dissolve at the time of the onset of the attack. The drugs in this group include Enap or Enam.
Means relaxing smooth muscles
In fact, these are drugs that have a muscle relaxant effect. It is thanks to this quality that the lumen expands and as a result, blood pressure decreases. In fact, this is one drug - Dibazol, which is often used in therapy with papaverine.
Diuretics
The most commonly used loop diuretics. It is these drugs that have an almost instant effect. The most commonly used is Furosemide.
The main quality of these drugs is that they can be used at any time, and in order to increase the effect, it is only necessary to increase the dosage.
Nitrates
This series of drugs is often used to treat coronary artery disease. When stopping the crisis, the following drugs are used: Naniprus or Niprid, that is, those where the active substance is sodium nitroprusside.
Drugs are administered intravenously, drip. Depending on the condition of the patient, the dose may be from 0.25 to 10 milligrams per kilogram of weight.
Features of crisis relief
To stop the crisis as quickly as possible, medications are administered intravenously or given for resorption under the tongue. This is due to the fact that very often in this state, patients have nausea, which does not allow taking the drugs orally. Moreover, after taking the pill, the drug is absorbed for a long time in the gastrointestinal tract. Also, against the background of the attack, narrowing of the small arteries is observed, namely, they should participate in the process of absorption into the bloodstream. If the tablet dissolves, then the active substance is absorbed not only through the blood, but also through the mucous membrane, hence such a quick effect.
As a rule, drugs from different groups are used comprehensively in order to achieve positive dynamics as quickly as possible and to avoid complications of the crisis.
What to do after an attack?
First of all, the patient will have to constantly monitor blood pressure indicators, and this procedure is indicated for life. You will have to take medication to reduce pressure throughout your life.
Whenever possible, stressful situations should be avoided. Remove heavy physical exertion from your life. Only sport should be present, but in moderation and not too stressful, it can be yoga, gymnastics.
Have to give up smoking and drinking alcohol. In no case should obesity be allowed. On an ongoing basis, it is necessary to maintain the water balance at the proper level, that is, use at least 1.5 liters of water per day. It is necessary to refuse harmful products, fried and fatty foods. Fiber, cereals, vegetables and fruits should be present in the diet.
Every person who has survived an ischemic stroke must adhere to these rules in order to prevent its recurrence, and visit a doctor regularly.