Hypertensive crisis

Short characteristic of a disease

Hypertensive crisis is understood as sudden, sharp increase in arterial pressure to a mm mark 220/120 рт. column above. If help at hypertensive crisis was given too late, then the disease can lead to irreversible neurovegetative disorders of heart, central nervous system and large blood vessels. However, considering the level of equipment of modern medicine, similar effects are a rarity. But you anyway should address to clinic and to take care of the health, supertension during hypertensive crisis remains from several hours to several days, being followed by psychological and physical discomfort.

Reasons of development of hypertensive crisis

Sudden increase in pressure can be the result of the psychoemotional tension, the use of a large number of alcoholic beverages, sharp change of weather conditions and reception of some medicines, for example, of clonidine or beta андреноблокаторов.

In addition to the above-stated reasons, hypertensive crisis arises at various diseases, for example, arteriosclerotic damage of an aorta, a nodular polyarteritis, a system lupus erythematosus, a diabetes mellitus, diseases of kidneys and a nephroptosis. It should be noted that all listed diseases, as a rule, do not cause hypertensive crisis directly, but they promote emergence of wet brains which raise the ABP.

Hypertensive crisis – symptoms and a clinical picture of a disease

The modern medicine claims that acute management at hypertensive crisis has to be given the first minutes after the beginning of an attack. It is connected with unpleasant symptoms which follow after sudden increase in the ABP. Among them we would like to note:

• sensation of fear, concern for the least thing;
• fever, hyperemia;
• face edemas;
• deterioration in sight;
• strong and long attacks of vomiting;
• the neurologic disturbances which are followed by dissociation of reflexes

Besides, increase in the ABP quite often leads to an aggravation of a course of coronary heart disease, development of tachycardia, a pronounced pain syndrome. Urgent stopping of hypertensive crisis is necessary when it is followed by a fluid lungs, a coma, an embolism of arteries and an acute renal failure.

In some cases, at the made diagnosis hypertensive crisis, symptoms testify about increase in both systolic, and diastolic pressure. Help has to be given in such situation for the prevention of heavy complications as soon as possible. Gipoinetichesky and eukinetichesky crises proceed more favorably. Their development is followed by rise in either systolic, or diastolic pressure. Therefore, symptoms of a disease accrue slowly and the sick person has much more time to see a doctor and to receive the qualified help at hypertensive crisis.

We mentioned above that in most cases increase in pressure does not lead to serious effects. The only exception – the complicated hypertensive crisis, life-threatening the person. Its symptoms appear at such states as: subarachnoidal hemorrhage, stroke, left gastric insufficiency, fluid lungs, hamaturia and acute myocardial infarction.

Hypertensive crisis – treatment of a disease

The bed rest and lack of psychological loadings is recommended to patients. Besides, it is desirable to limit meal. The optimum scheme of a diet – 10 or 10a. It should be noted that stopping of hypertensive crisis has to be gradual as sharp pressure decrease is not less dangerous, than its sudden raising. If decrease in the ABP is made too quickly, it can provoke ischemia of kidneys, development of a stroke or myocardial infarction. Acute management at hypertensive crisis means use of the following drugs:

• the clonidine – is accepted inside each hour at first on 0,2 mg, and then on 0,1 mg;
• nifedipine – is produced in capsules or tablets. A standard dosage – 5-10 mg (1 tablet) under language;
• Sodium nitroprussidum – is entered intravenously. If the expected effect is not observed, administration of drug is stopped;
• diazoxide – is entered intravenously, a dosage – 50-150 mg. This means is applied with care as it can cause side effects – stenocardia, hypostases, nausea, vomiting;
• phentolamine – 5-15 mg intravenously, is especially effective at the hypertensive crisis connected with a pheochromocytoma.

Acute management at hypertensive crisis

As the disease develops very quickly, you have to know about the main receptions allowing to stop sudden increase in pressure. First of all, dial number of the station of "Ambulance" and call specialists, briefly having described current situation. Then put the patient to bed. An optimal variant – a comfortable semi-sitting position on the spread-out pillows. Such pose will allow to avoid suffocation attacks – an orthopnea. Warm the patient's legs. For this purpose wrap up them with a warm plaid with a hot-water bottle or lower feet in a hot bathtub. Well also the mustard plasters put on a shin help.

Provide inflow of fresh air to the room. If hypertensive crisis arises not for the first time, then the patient for certain has tablets which need to be accepted in similar situations. Find them and ask the victim on a dosage. At emergence of severe chest pains it is possible to give to the patient nitroglycerine.

Do not forget also about psychological support of the patient. It is important at any disease, but during hypertensive crisis warm and tender words are especially necessary, very often the person begins to panic because of misunderstanding of a situation that only aggravates its state. Calm the victim, talk to him, convince him that everything will be good. We assure that in this case stopping of hypertensive crisis will take place most quickly and without serious consequences.