Hypertensive crisis

A sudden strong increase in the induction of humoral and neurovascular disorders called a hypertensive crisis.

The occurrence of this pathology contributes to the discontinuation of drugs to reduce the pressure, sudden weather changes, alcohol abuse, mental stress and so on.

This disease is manifested by vomiting, nausea, appearance before the eyes of the fog, dizziness, headache. A characteristic feature is a feeling of heaviness in the chest. The crisis may develop suddenly. There are hypokinetic and hyperkinetic crises. The pressure increase in the hyperkinetic crisis often caused by excessive work of the heart increases cardiac index). When the crisis hypokinetic the pressure increases due to increased peripheral resistance. The doctor, providing first aid, may not qualify the type of crisis, therefore, hypertensive crises are divided according to their clinical manifestations. According to this division the crisis may be the first and the second type, as well as complicated.

Hyperkinetic (first type) crisis develops quickly. The patient abruptly headache, eyes flashing, nausea (possible and vomiting), dizziness. The patient is excited, feels the trembling of the body, sensation of heat. On the skin of the breast, face and neck appear red spots. The skin is moist to the touch. There is a feeling of heaviness in the chest, the heart rate increases. Pulse and systolic pressure increases in urine celebrate isolated erythrocytes and proteinuria. Often the crisis of the first type ends copious urination. This type of stroke is usually observed in patients with essential hypertension the first stage, its duration is several hours.

Hypokinetic (second type) crisis usually occurs in patients with hypertension the third stage when the violation of life mode and ineffective treatment. The symptoms of this crisis is growing more slowly, but very intense. In a patient with headache, deteriorating hearing and sight, appear lethargy, vomiting, nausea. The pulse Ochsen, but tense, diastolic pressure is increased. In the urine see a large number of erythrocytes, cylinders and protein.

Complicated form of crisis may occur in asthma, coronary or cerebral version. On the background of high pressure may develop cardiac asthma and pulmonary edema, coronary insufficiency, hypertensive encephalopathy, ischemic or hemorrhagic strokes.

When the crisis first type are injected Dibazol (1 % solution), at the same time prescribe diuretics (furosemide, lasix). If the crisis is accompanied by arrhythmia or tachycardia use of beta-blockers.

When the stroke of the second type is a good hypotensive effect of clonidine, it is injected (glucose solution).

The most complex in the treatment of complicated type of hypertensive crisis, especially if there are signs of disorders of the coronary or cerebral circulation. To relieve this crisis shows the use of neuroleptics, intravenously, slowly. The positive effect becomes visible after a few minutes and reaches its maximum by the fifteenth minute. The disadvantage is the low duration of effect (up to one hour). So along with neuroleptics used antihypertensive drugs in combination with diuretics.

Patients with complicated or nekupirutayasa stroke, and patients with hypertensive crisis happened for the first time after the provision of emergency medical care are admitted to a medical or cardiology.

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