Hypertensive crisis is fraught with many serious dangers and serious consequences for the whole organism. Complications of a hypertensive crisis can affect a variety of organs.
How to determine the complications of this pathology? How to provide emergency assistance in detecting primary or secondary symptoms? And what is the best way to choose a treatment for complications of a hypertensive crisis? Let's find out.
And in the beginning we’ll try to briefly understand what a hypertensive crisis is, how it provokes and how to avoid it.
Hypertensive crisis
Hypertensive crisis is a sharp increase in blood pressure, characterized by the severity of the patient's condition and affecting many internal organs. The cause of this ailment is a pathology of the cardiovascular system and a chronic lack of blood supply.
Causes of hypertension
The reason for the occurrence of a hypertensive crisis can be a stressful situation and intense physical activity, which provoke a heartbeat and an increase in pressure.
Typically, a hypertensive crisis occurs against the background of chronic hypertension, when an ill person takes drugs on an irregular basis to reduce blood pressure, personally changes their dosage or abuses coffee, alcohol and salt.
What can provoke hypertension?
- Traumatic brain injuries.
- Chronic diseases (aortic atherosclerosis, diabetes, lupus, periarteritis nodosa, kidney disease).
Of course, a crisis does not always arise due to the above reasons. Often, stress or hypothermia, high physical activity or the use of hormonal drugs, sudden changes in weather, or hormonal failure contribute to it.
According to observations, mainly the elderly are affected by the hypertensive crisis, especially the stronger sex from the age of fifty-five.
Symptoms of a hypertensive crisis
It is generally accepted that the main criterion for recognizing a disease is a sharp jump in pressure to a mark of 200 and above. However, this is not always the correct indicator.
For different people, there are different signs of a critical condition. It all depends on the patient's working pressure. For example, if a person feels great at indicators 90/60, then the mark 140/90 will be considered critical for him, which will mean the beginning of a hypertensive crisis.
And vice versa, if a patient feels well at a pressure of 140/90, then an increase in indicators to 160/110 and even up to 170/120 will not cause negative consequences for him.
Therefore, the combination of symptoms plays a decisive role in determining the hypertensive crisis. It can be:
- headache and dizziness;
- nausea and weakness;
- a feeling of panic and fear;
- visual impairment;
- heart pain and tachycardia;
- sweating or chills;
- cramps and limited movement;
- shortness of breath and partial loss of consciousness.
Optionally, all of these symptoms will be present during a hypertensive crisis. How then to diagnose this condition?
Definition of a hypertensive crisis
For this, first of all, it is necessary to regularly measure pressure every fifteen minutes. If a high pressure is kept for a long time (indicators are taken into account in accordance with the patient’s working pressure), then the patient has a hypertensive crisis.
In addition, pulse diagnostics, measuring body temperature, listening to the heart and lungs, and conducting a cardiogram will be considered important diagnostic measures.
Yes, a hypertensive crisis is a very dangerous condition. But complications of a hypertensive crisis are considered no less dangerous. According to statistics, more than forty percent of patients who have been diagnosed with hypertensive crisis have died from its effects over the next three years.
It is noteworthy that the types of hypertensive crisis are determined according to its complications. Let's talk about this in more detail.
Possible complications of the disease
Complications of a hypertensive crisis are:
- Cerebral infarction. The most common complication of the crisis occurs mainly in 24% of patients.
- Pulmonary edema. It is observed in 22% of patients.
- Cerebral edema. It is noted in 17% of patients.
- Acute left ventricular failure. It occurs in 14% of patients.
- Myocardial infarction. It is observed in 12% of patients.
- Eclampsia. It is noted in 4.6% of patients.
Possible complications of a hypertensive crisis include:
- hemorrhages of various forms;
- angina pectoris;
- acute renal failure ;
- hemiparesis;
- an acute form of retinopathy;
- encephalopathy;
- stroke;
- com;
- fatal outcome.
Let's discuss it in more detail.
Common complications
Serious complications after a hypertensive crisis often relate to the human brain. For example, cerebral infarction, or ischemic stroke. This is an acute circulatory disturbance as a result of blockage of the arteries of the brain. Or cerebral edema, in which the outflow of cerebrospinal fluid is disrupted, and due to an increase in its volume, pressure on the tissues increases.
What signs do other common complications of a hypertensive crisis have? Pulmonary edema is another serious pathological consequence of this ailment. It is characterized by a violation of the amount and outflow of intercellular fluid, as well as its abundant accumulation in the lungs.
What negative effect does the hypertensive crisis have on the human heart? Complications of hypertension can be caused by such dangerous and severe pathologies as heart failure and myocardial infarction. The first of them is caused by a violation of coronary blood flow, during which blood, without entering the aorta, stagnates in the left ventricle, and the right one is filled to unacceptable limits.
Myocardial infarction is accompanied by necrosis of this site due to insufficient blood supply.
An equally common and dangerous complication of a hypertensive crisis is eclampsia, which develops suddenly. It manifests itself during pregnancy or childbirth, and is caused by extremely high blood pressure, so that there is a threat to the life of both the mother and the baby.
Other complications
Possible complications of a hypertensive crisis include hemorrhage under the arachnoid membrane of the brain and intracerebral hemorrhage. The first type of complication is the result of a violation of cerebral circulation, during which blood accumulates under the thin arachnoid membrane of the brain.
Intracerebral hemorrhage is caused by rupture of the walls of the cerebral vessels and the ingress of blood into the substance of the brain.
Complications of a hypertensive crisis are encephalopathy and hemiparesis. Encephalopathy is a non-inflammatory disease of the brain in which dystrophic changes in the brain tissue occur, which violates its functionality. Hemiparesis is accompanied by damage to brain neurons and is a partial muscle paralysis.
What other fatal ailments does a hypertensive crisis entail? Kidney complications cause poor circulation due to hypertensive crisis. This condition negatively affects the filtering process. Blood clots form in the capillaries and urination partially or completely stops. The body suffers from intoxication, which increases the likelihood of inflammation of other organs.
In addition, the consequence of the crisis may be acute renal failure, which also leads to disruption of the filtering and reabsorption processes. Disrupted water, nitrogen, electrolyte and other types of metabolism.
Does hypertensive crisis provoke eye complications? Yes, as the result of acute hypertension, complex and unpleasant diseases such as retinopathy and amaurosis can occur.
Retinopathy is an inflammatory process in the retina that causes circulatory disorders in it, which can lead to retinal degeneration and even blindness. Amaurosis is also a serious lesion of the retina, as well as the optic nerve, which can cause partial or complete blindness.
As you can see, complications of the hypertensive crisis affect very important organs of the human body, such as the heart, lungs, kidneys, and eyes. They can lead to severe chronic ailments or irreparable fatal consequences.
However, do not blame hypertension in all complex incurable diseases. It should be remembered that the complications of a hypertensive crisis do not include cardiac, renal and other diseases provoked by inflammatory processes, since these types of ailments are the result of infectious and viral pathologies.
So, we found out what constitutes a hypertensive crisis and its complications. The conclusion from the foregoing is as follows: methods of treating a hypertensive crisis depend on the type of its complications.
Hypertensive crisis: complications and treatment
Since a hypertensive crisis can negatively affect various organs of the human body, treatment should be started in accordance with which organs were affected and the severity of this lesion.
In these cases, pressure reduction is not a priority and priority measure. However, in order for the treatment to have a quick effect, you should still try to bring down blood pressure by at least twenty units.
How are complications of a hypertensive crisis treated? First of all, this is done on an inpatient basis, not on an outpatient basis. Remember, only in a medical facility will you be under constant control and supervision. And only there you will be provided with effective and efficient treatment.
First of all, it can be intravenous infusions of nitroglycerin or sodium nitroprusside, which will need to be immediately canceled as soon as the blood pressure is normal. The action of these drugs begins in three to five minutes, however, their introduction into the body can be accompanied by nausea and vomiting, convulsions and tachycardia and other adverse reactions. In addition, it should be remembered that these injections are prescribed for high risk of encephalopathy, acute left ventricular failure, aortic dissection. However, they are not prescribed for renal or liver failure, glaucoma and other specific diseases.
Other medications for hypertensive crisis may be beta-blockers, which not only lower blood pressure, but also slow down the heartbeat. These drugs are prescribed for acute myocardial ischemia and stratification of the aortic aneurysm, but they should not be taken for those who have a history of acute heart failure, bronchial asthma, and sinus node weakness.
The next group of drugs - alpha-blockers - are used only with a high level of catecholamines.
In case of complications of a hypertensive crisis, Methyldopa and magnesium sulfate are prescribed on the brain. The first medicine has a positive effect on the underlying mechanisms of the brain. It can also be used for hypertensive attacks in pregnant women. However, it should be remembered that pheochromocytoma, heart attack, cerebrovascular disease, etc. are contraindications to the use of this drug.
Magnesium sulfate is prescribed for the threat of cerebral edema and for seizures. It should be administered very slowly, so as not to cause lung spasms and asthma attacks. The drug begins to act twenty minutes after injection and provides an effect within six hours.
Another medicine for hypertensive crisis may be hydralazine, which is used for eclampsia, to expand arterial vessels. The drug begins to have an effect ten minutes after administration and has a rather long-lasting effect.
Enalaprilat is a very effective remedy for encephalopathy, heart failure, coronary syndromes. Since the medicine begins to act almost instantly, it should be administered extremely slowly and carefully.
These medications mentioned above are specialized pharmacological agents that should be used only as directed by the attending physician.
Therapeutic methods
However, in addition to injections and pills, the doctor may prescribe therapeutic treatment. First of all, it is an opportunity for the patient to relax and rest, whether it is a dream, a nap or a massage. You should also avoid any stress and anxiety, no matter how emotional they are saturated.
In addition to peace and quiet, the patient will need a special diet, with which it will be necessary to avoid foods that put extra strain on the heart muscle. You should completely abandon salt and spices, eat in small portions and only lean, low-fat food.
In addition, the body will need to be nourished with useful trace elements and vitamins, for which medications or vitamin-rich foods (vegetables and fruits) can be prescribed.
First aid emergency
Now let's talk briefly about what needs to be done when complications of a hypertensive crisis arise. Emergency care to the patient is to provide him with peace and an influx of fresh air, to reassure and assure the imminent arrival of qualified care.
As a sedative, you can use any improvised medicines - valerian, corvalol, motherwort. You also need to monitor to even out the patient’s breathing, for this you can help him remove his clothes and ventilate the room.
What is the best position to take? The patient should be placed in a semi-sitting position. If he feels cold, you must try to warm him. However, it is still worth putting a cold compress on your forehead.
In acute cases, an ambulance should be called. You can also take special medications to lower blood pressure.
However, the main principle applies here: do no harm! Therefore, if you decide to help the patient lower the pressure, this must be done slowly and carefully, preferably with drugs already known to him or you.
Often, the patient himself has knowledge of how to block an attack. Usually he always has with him medicines that can be taken if necessary. Outside help can also come in handy here. You may need to bring water to swallow the capsule. Or you will need to do an intramuscular injection.
Anyway, to help the patient is a very noble and worthy act. Call an ambulance, help to recover, just stay close - such selfless beneficence will save the life of another and will certainly be rewarded.