Vascular insufficiency

Short characteristic of a disease

Vascular insufficiency is a disturbance of local or general circulation which cornerstone the insufficiency of function of blood vessels caused in turn by disturbance of their passability, reduction of a tone, volume of the blood passing on them is.

Insufficiency can be system or regional (local) – how disturbances extend. Depending on rates of a course of a disease there can be an acute vascular insufficiency and chronic.

True vascular insufficiency meets seldom, most often along with symptoms of vascular insufficiency insufficiency of a cardiac muscle is shown. Warmly vascular insufficiency develops because the cardiac muscle and muscles of vessels are influenced often by the same factors. Sometimes warmly vascular insufficiency is secondary and pathology of heart arises because of bad food of a muscle (a lack of blood, low pressure of arteries).

Emergence reasons

As cause of illness usually serve the disturbances of blood circulation in veins and arteries which arose for various reasons.

Generally acute vascular insufficiency develops because of the postponed craniocereberal and general injuries, various heart diseases, blood loss, at morbid conditions, for example, at acute poisonings, heavy infections, extensive burns, organic lesions of a nervous system, adrenal insufficiency.

Symptoms of vascular insufficiency

Acute vascular insufficiency in the form of a faint, shock or a collapse is shown.

Syncope – the easiest form of insufficiency. Symptoms of vascular insufficiency at a faint: weakness, nausea, blackout, bystry loss of consciousness. Pulse weak and rare, pressure is lowered, integuments pale, muscles are relaxed, there are no spasms.

At a collapse and shock the patient is in most cases in consciousness, but its reactions are slowed down. There are complaints to weakness, the lowered temperature, and pressure (80/40mm.rt.st less), tachycardia.

The main symptom of vascular insufficiency is the sharp and bystry lowering of arterial pressure which provokes development of all other symptoms.

Chronic insufficiency of function of vessels is most often shown in the form of arterial hypotension. Conditionally this diagnosis can be made at such symptoms: children of advanced age have lower than 85 systolic pressure, to 30 l. – pressure is lower than level 105/65, at persons of more advanced age – lower than 100/60.

Diagnosis of a disease

At a survey stage the doctor, estimating symptoms of vascular insufficiency, distinguishes what form of insufficiency was shown, syncope, shock or collapse. At the same time the level of pressure is not decisive in diagnosis, it is necessary to study a case history and to find out the attack reasons. Very important at a stage of survey to establish what type of insufficiency developed: cordial or vascular since acute management at these diseases is given differently.

If warmly vascular insufficiency was shown, the patient is forced to sit - in lying situation its state considerably worsens. If vascular insufficiency developed, the patient needs to lie since in this situation his brain is better supplied with blood. Skin at heart failure – pinkish, at vascular – pale, sometimes with a grayish shade. Also vascular insufficiency is distinguished that venous pressure is not increased, veins on a neck fallen down, borders of heart are not displaced, and there is no stagnation, characteristic of cardiac pathology, in lungs.

After the preliminary diagnosis on the basis of the overall clinical picture is made, the patient is given first aid, if necessary hospitalize, appoint inspection of bodies of blood circulation. For this purpose to it can appoint to pass auscultation of vessels, an electrocardiography, a sfigmografiya, a flebografiya.

Treatment of vascular insufficiency

Medical care at vascular insufficiency should be provided immediately.

At all forms of development of acute vascular insufficiency of the patient it is necessary to leave in lying situation (otherwise there can be a lethal outcome).

If there was a syncope, it is necessary to weaken clothes on the victim's neck, to clap it on cheeks, to sprinkle a breast and a face water, to allow to smell liquid ammonia, to air the room. These are manipulations it is possible to carry out and independently, usually positive effect occurs quickly, the patient recovers consciousness. After surely it is necessary to call the doctor who having conducted on site simple diagnostic testings, will enter subcutaneously or intravenously caffeine solution with sodium benzoate of 10% - 2 ml (with the recorded lowered pressure). If the expressed bradycardia is noticed, in addition enter atropine of 0,1% 0,5-1ml. If bradycardia and the lowered pressure remain, intravenously enter орципреналин sulfate of 0,05% - 0,5-1ml or solution of adrenaline of 0,1%. If through 2-3min the patient still remains unconscious, pulse, pressure, cardiac sounds are not defined, there are no reflexes, begin to administer these drugs already vnutriserdechno, and perform CPR, a cardiac massage.

If after a faint additional resuscitation actions were necessary, or the reason of a faint remained obscure, or it happened for the first time, or the patient's pressure after his reduction in consciousness, remains lowered, he needs to be hospitalized for further inspection, treatment. In all other cases hospitalization is not shown.

The patients with a collapse who are in a depressed case irrespective of the reason which caused this state are urgently taken to hospital where the patient is given the first acute management on maintenance of pressure and action of the heart. If necessary stop bleeding (if it is necessary), carry out other procedures of symptomatic therapy, being guided on the circumstances which caused an attack.

At a collapse cardiogenic (often develops at warmly vascular insufficiency) eliminate tachycardia, stop atrial flutters: apply atropine or Isadrinum, adrenaline or heparin. For recovery and maintenance of pressure enter subcutaneously a phenylephine hydrochloride of 1%.

If the collapse is caused by an infection or poisoning, subcutaneously enter caffeine, cocarboxylase, glucose, sodium chloride, ascorbic acid. It is very effective at this type of a collapse strychnine of 0,1%. If such therapy of result did not bring, enter under skin a phenylephine hydrochloride, into a vein преднизолонгемисукцинат, again enter sodium chloride of 10%.

Prevention of a disease

The best prevention of insufficiency of function of vessels is the prevention of diseases which can cause it. It is recommended to watch a condition of vessels, to use less cholesterol, to undergo regular inspections of system of blood supply and heart. In some cases to hypotensives appoint a preventive rate of the drugs supporting pressure.