Hypertensive crisis: danger, causes, treatment
Hypertensive crisis is a very serious pathological condition caused by a significant increase in blood pressure (BP). Emergency care for a hypertensive crisis involves taking measures to quickly lower blood pressure, otherwise the risk of possible complications, in which the so-called "target organs" are affected, increases significantly. First of all, the brain, kidneys and heart muscle are affected; sometimes pulmonary edema occurs.
With a severe course, such complications of hypertensive crisis as myocardial infarction and strokes (mainly hemorrhagic) are possible.
Causes and signs of hypertensive crisis
This pathological condition is the most dangerous for persons who have previously been diagnosed with cardiovascular pathologies and damage to the central nervous system.
Vascular regulation and increased cardiac output are considered the main causes of hypertensive crisis. Against the background of spastic contraction of arterioles, peripheral resistance increases and the heart rate increases in parallel. When blood vessels spasm in organs, oxygen starvation begins.
According to the clinical classification, there are complicated and uncomplicated types of hypertensive crisis. In the first case, target organs are damaged. A complicated crisis often becomes the cause of death, so it is a reason for immediate hospitalization after providing emergency care in full. In an uncomplicated course, the brain and internal organs are affected to a much lesser extent, and treatment can be carried out in an outpatient setting (at home). Nevertheless, adequate measures must be taken within the first day after the appearance of clinical signs. Pre-medical care is of great importance in a hypertensive crisis.
The first symptoms of a hypertensive crisis include:
- A sharp jump in blood pressure (systolic – above 150-200);
- intense cephalgia (in the temporal and occipital regions);
- chest pains;
- appearance of shortness of breath;
- flickering of flies and glare before the eyes;
- vomiting;
- excitement;
- hyperemia of the skin.
Symptoms of a hypertensive crisis often include such neurological disorders as convulsions and confusion (loss of) consciousness.
What to do to alleviate the patient's condition
Please note: Attacks tend to recur. According to statistics, they develop in 1% of people diagnosed with chronic arterial hypertension.
Complex treatment of hypertension is essential for the prevention of these emergency conditions.
The outcome of the attack depends on the skillful actions of the patient's relatives and friends. But it is important to take into account that even the most competent medical care in case of a hypertensive crisis will never replace the actions of the medical team. First of all, the patient must call an "ambulance"!
Algorithm of actions in hypertensive crisis:
- the patient should be reassured; emotions can provoke a further increase in blood pressure;
- the patient should be helped to acquire a semi-sitting position;
- ensure air access to the room;
- remove or unbutton the patient's clothing, which makes it difficult for him to breathe;
- make sure that the victim's breathing is deep and even;
- it is advisable to put a bag or a warmer with ice on the head;
- give the patient the medicine he usually takes to lower blood pressure;
- give 20-40 drops of Corvalol;
- cover the patient with a blanket in case of chills;
- if there are chest pains, give a Nitroglycerin or Nitrokor tablet (no more than 3 tablets in total);
- put 1 Captopril tablet under the patient's tongue (possible substitutes are Kordaflex, Kapoten, Nifedipine, Corinfar).
Important: If after 30 minutes there is no noticeable improvement in the condition, the "ambulance" has not yet arrived, then to stop the hypertensive crisis, give the victim the medicine from the above list again.
Use a tonometer to measure blood pressure every 15-20 minutes and record the results so that doctors can objectively assess the dynamics of the condition.
Medicinal means for stopping the crisis
In the case of an uncomplicated course, diuretics are indicated to reduce the volume of circulating blood and muscle relaxant Dibazol to dilate blood vessels. If extrasystole or palpitations are detected, urgent care for a hypertensive crisis involves intramuscular or intravenous administration of drugs from the group of β-blockers - Propranolol, Anaprilin, Atenolol, Obzidan or Rausedil.
In order to quickly reduce blood pressure in a complicated crisis, Hyperstat or Diaxizon is administered intravenously, and Corinfar or Nifedipine is given sublingually (under the tongue) (if the patient has not taken these drugs more than once before the arrival of the doctors). Clofelin, Hemiton or Katapresan may be prescribed.
Complicated hypertensive crisis is an indication for the administration of a neuroleptic drug - Droperidol. If there are signs of heart failure (left ventricular) against the background of a significant increase in blood pressure, one of the ganglioblockers and a diuretic (Lasix) should be administered to the patient.
Acute coronary insufficiency requires the use of strong analgesics (including narcotics). Nitrates (Sustak, Nitrosorbide, Nitrong) or sodium nitroprusside (50 mg IV) are needed to expand the lumens of arteries and arterioles.
During the provision of first aid for a hypertensive crisis, pressure is periodically monitored. During the first 2 hours from the start of therapy, systolic pressure should be reduced by 20-25%. The doctors need to be informed of the normal parameters of the victim. If the "working" pressure is 140/90, then you should not try to reach the "standard" of 120/80. It is important to reduce blood pressure gradually, as its sharp drop can cause the development of a colaptoid state.
Usually, intravenous and intramuscular forms are preferred, since vomiting makes taking oral agents ineffective.
If a convulsive syndrome develops, Seduxen (Relanium) 0.5% 2 ml is administered intravenously (slowly) to the patient.
How to prevent a crisis, the therapist will tell you, and you can make an appointment with him on our website https://dobrobut.com
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