Symptoms of a hypertensive crisis

In the clinical picture, the hypertensive crisis has a variety of symptoms.

This phenomenon in the practice of modern doctors is common and is characterized by neurovegetative imbalance, as well as serious complications from the internal organs. Arterial pressure in this case can reach 220/120 mm Hg. Art., may be higher. Such a crisis condition is formed only against the background of hypertension and has some prerequisites for its development.

Etiology of the crisis

Statistics reflect that thirty percent of patients with arterial hypertension necessarily have a crisis. Persons with a malignant course of the disease are more susceptible to it; it is often found in elderly men and in menopausal women.

Against the background of the chronic course of hypertension, a crisis occurs due to the following reasons:

1. Psycho-emotional tension, stress, worries and strong unrest.
2. Changes in the weather for weather-sensitive persons, the influence of a changed magnetic field.
3. Inaccuracies in nutrition, excess salt and saturated fats in the diet, abuse of fast food and alcohol.
4. Abrupt withdrawal of antihypertensive drugs, especially clonidine or beta-blockers.

Often, a case of a hypertensive crisis allows the patient to learn about his illness and chronic high blood pressure.

The symptoms of this pathological process can be so hidden that a person may not be aware of his condition for a long time.

Blood pressure in both men and women is regulated by many systems. They are located in almost all organs and work as a well-coordinated mechanism, smoothing out pressure surges when it decreases or increases. But the forces of such adaptive systems are not unlimited, and this whole intricate mechanism can fail.

The pressure usually does not rise sharply and for a long period of time. Vessels and other vital organs are also able to adapt to high pressure. Naturally, they suffer somewhat, lose their elasticity, expand, and do not fully fulfill their function. The imposition of the factors described above forms severe manifestations of a hypertensive crisis. Its danger lies in the fact that a person is not ready for a sharp increase in pressure, does not know what his symptoms are, how to effectively and quickly deal with it.

But the statistics reflect that patients with advanced stages of malignancy are more prone to exacerbation of hypertension, which is also accompanied by atherosclerosis.

If crises occur repeatedly and fairly regularly, this indicates a neglect of treatment.

Frequent crises are provoked by factors such as:

• chronic stress;
• abuse of alcohol or caffeine-based drinks;
• poor diet with excess salt;
• abrupt withdrawal of antihypertensive drugs, when the patient forgets about the need to take medications.

Hypertension in combination with atherosclerotic vascular lesions is severe and malignant. The sudden onset is replaced by a long duration and severe relief of symptoms.

Hypertension of this type is complicated by visual and auditory disorders, in particular, ringing in the ears, darkening of the eyes. Dizziness, nausea and vomiting are intense, in men the potency decreases, in women hot flashes are observed.

Headache may be accompanied by pain in the eyeballs: a person cannot look freely to the sides, he is afraid of bright light. The patient may be inhibited and stunned, poorly oriented in space, lose consciousness.

Therefore, it is so important to know about the symptoms of a hypertensive crisis, which will help in a dangerous situation not only to people around you, but also to yourself.

Only an attentive attitude to your health will allow you to recognize the growth of hypertension in a timely manner and eliminate it at the earliest stages, when the treatment consists of:

• in elementary diet;
• in the loss of excess weight;
• in giving up bad habits.

Signs of pathology

A hypertensive crisis is manifested by an unexpected increase in pressure with extensive neurosomatic symptoms. First of all, the blood circulation of some organs suffers - the brain, kidneys, cardiovascular system. This is how the threat of dangerous complications of the crisis is formed - hemorrhage in the brain, the formation of an infarction zone in the heart and pulmonary edema, kidney failure.

Signs of a hypertensive crisis at the stage of its development are as follows:

1. Excessive excitement for no apparent reason or danger.
2. Nervous excitement in the absence of reception of tonic drinks.
3. Rapid heartbeat without physical exertion and other stressful influences.
4. Feeling of lack of air even in a well-ventilated room, on the street.
5. Cold sweat in the absence of an infectious process and inflammation.
6. "Goosebumps" in a room with optimal temperature.
7. Hand tremor or tremor outside of neurological pathologies.
8. Redness of the face in the absence of dermatological disorders, menopausal manifestations in women.

Already in the early stages of the development of the crisis, there is a headache with a feeling of nausea, often turning into vomiting, ringing in the ears, and a state of dizziness. Pain is aggravated by straining at the time of defecation, coughing and sneezing. When looking at the light, the patient may also notice an increase in pain.

A detailed study of the clinical picture of hypertension and its exacerbation made it possible to classify headache:

1. A typical sensation of paroxysmal pain over the entire surface of the head. Complaints of patients usually define pain as throbbing or squeezing temples, dull, pressing. Pain occurs mainly when going to bed or after a night's rest.
2. An atypical headache associated with a neurasthenic condition, usually affecting one side of the head.
3. Headache as the main symptom of malignant hypertension. The reasons for this are formed on the basis of increased pressure inside the skull, swelling of the brain.

Dizziness as a sensation of rotation of objects also accompanies a hypertensive crisis.

This symptom is also divided into two subspecies:

• dizziness arising from a change in the position of the head;
• dizziness at rest.

Etiologically, the symptoms are associated with dystonic phenomena in the vertebral and carotid arteries.

Neurological disorders in hypertension are even more diverse and are determined by the stage of the underlying disease.

All three stages of hypertension have their own causes and manifestations:

1. The first stage of hypertension is characterized by neurotic symptoms that are associated with a decrease in the function of the hypothalamus.
2. At the second stage, the hypothalamus loses its functionality even more, which is reflected in the violation of many types of metabolism, endocrine insufficiency.
3. The third stage has already more pronounced dyscirculatory symptoms, which is reflected by impaired blood circulation in the brain.

Hypertensive crises vary widely in duration. A complete picture of the pathological condition can unfold in an hour, or maybe in a few days. The indicator of blood pressure at which a crisis is noted is also different and has individual characteristics.

So, already at 130/90 mm Hg. Art. some hypotensive patients feel the entire picture of the crisis described above, while for other patients the achievement of these figures is accompanied by an optimization of the state.

Crisis classification

The causes and symptoms of a hypertensive crisis are so diverse that they can be classified according to many parameters. However, a crisis of any etiology and mechanism of development requires emergency care and relief of its manifestations.

According to the mechanism of manifestation

The first classification parameter is the pressurization mechanism. For this, an important point is established: whether the output of blood by the heart increases or whether vascular resistance increases.

In this regard, hypertensive crises are:

1. Hyperkinetic. They are characteristic of the early stages of hypertension, develop quickly, without previous symptoms. Patients complain of a sharp headache of a throbbing nature with "flying flies". Nausea is often replaced by uncontrollable vomiting. The patient is usually anxious, panicky, trembling and sweating profusely. The skin acquires a hyperemic color, becomes moist. The pulse is palpable, the heartbeat quickens. Usually the systolic index rises strongly, the diastolic pressure increases moderately. The heart is under increased stress, which can be the cause of pain behind the sternum. A crisis of such a plan usually does not give complications.
2. Hypokinetic crises are formed with an increase in resistance from the vessels. They are typical for patients with a long history of hypertension in the primary or secondary form of the disease. Symptoms of an acute condition are rarely pronounced, signs of a hypertensive crisis increase moderately. Vision and hearing change slightly, the pulse remains normal or decreases, the heartbeat slows down (bradycardia). Basically, diastolic pressure increases, which creates an afterload for the heart. A frequent complication of hypertensive crises are ischemic strokes.
3. Eukinetic crises are observed with an increase in both indicators of blood pressure. They develop quickly, but progress insidiously and usually do not carry complications. They are characteristic of "inveterate" hypertensive patients and are often repeated.

According to the presence of complications

Hypertensive crises are also classified according to the presence of complications from the organs most susceptible to high pressure.

According to this parameter, acute conditions of hypertension are:

1. Uncomplicated. They are characteristic of the early stages of the disease and do not pose a threat to vital organs. The pressure rises suddenly and can be quickly stopped. In the clinic, there may be a temporary stoppage of blood flow, which is expressed in the difficulty of mental activity and a sharp release of certain hormones. Patients complain of cognitive decline, anxiety, palpitations. An uncomplicated crisis begins with a sudden outbreak of headache, dizziness, nausea with vomiting. Patients may feel cold, short of breath, have difficulty breathing due to shortness of breath. Red edematous spots appear on the body with a predominance in the upper body. Pain in the region of the heart can be compressive in nature, the causes of which lie in the systemic load on the organ. Crises of this kind usually do not give complications, but still pose a threat to the life of patients due to the rather rapid development.
2. Complicated acute increase in pressure accompanies the later stages of the disease. The most frequent complications are vascular pathologies, one of which is hypertensive encephalopathy. It is she who gives her complicated symptoms - a stroke, a decrease in memory and concentration, the development of parkinsonism. On the part of the heart, angina pectoris, left ventricular hypertrophy, rhythm failures can develop. Often there is renal failure, decreased visual acuity due to swelling of the optic nerve.

Complicated crises form gradually, which gives rise to complications. Symptoms begin with ordinary drowsiness, a feeling of a “heavy head”, and a decrease in efficiency. Later, a headache, transient dizziness, shortness of breath and wet rales join. The feeling of lack of air worsens in the supine position, the room of such patients must be constantly ventilated. The skin turns pale, while the face becomes bluish in color. The pressure builds up gradually, which does not allow it to be quickly eliminated. If the measured indicator can be normalized, then the symptoms of a complicated crisis can persist for several days.

Hypertensive crises with complications received their classification in connection with the primary lesion of any organ:

1. Cerebral crises become the causes of encephalopathies, transient attacks, hemorrhages in the brain. To recognize the clinic of such a crisis allows the instability of the psyche of patients, increased diuresis. High pressure is especially detrimental to the state of such a part of the brain as the hypothalamus. Such patients are usually meteosensitive, prone to neurosis and depressive states. If the barometric pressure falls, then this is reflected in the condition of such patients. Crises often form attacks of the brain stem, which gives symptoms of dizziness, nystagmus, double vision.
2. Coronary hypertensive crisis impedes blood flow in the most important vessels of the heart, which gives a clinical picture of cardiac asthma and edematous condition of the lungs.
3. A neurovegetative crisis occurs with a significant release of adrenaline into the blood, which happens mainly against the background of chronic stress. In the first place are mental symptoms: anxiety, anxiety, decreased concentration, forgetfulness, trembling of the limbs. Later, shortness of breath, nausea and vomiting, sweating and fever join. The crisis is more or less benign, usually ends with profuse urination.
4. Edematous hypertensive crisis is associated with the failure of one of the main regulatory mechanisms of pressure - the renin-angiotensin-aldosterone system. These vasoactive substances are produced in the kidneys and maintain an optimal level of circulating blood volume. With abundant fluid intake and many other factors, edematous hypertensive crises occur with typical pasty phenomena. They may be accompanied by pain in the back of the head and along the brain stem, muscle weakness, an insatiable desire to sleep, disorientation in space and time, deterioration in visual acuity, auditory hallucinations. After the relief of high blood pressure, the symptoms of the disease may persist for a short time.
5. Convulsive complicated hypertensive crisis is the most dangerous. The phenomenon of a convulsive seizure is usually associated with a hemorrhage in the brain, which can lead to irreversible consequences. The condition is formed abruptly, the patient immediately loses consciousness and convulses. It is important to know about the episodes of such a pathology in the family and among the next of kin, since heredity in hypertension and its complications plays a predominant role.

Such an extensive classification allows doctors to form the most effective treatment when a patient enters a hospital with a hypertensive crisis.

Naturally, such a condition requires emergency care and urgent optimization of blood pressure. With the formation of this indicator, subsequent therapy is already required, the type of crisis and the likelihood of its complications are determined.

Prevention of high blood pressure

It is quite possible to prevent a hypertensive crisis if you are attentive to your health. Its prevention is similar to measures for hypertension.

Drug therapy should be supplemented by lifestyle changes, the rejection of bad habits, introduction to sports and physical activity. Even age-related atherosclerotic changes in blood vessels can be compensated by a balanced diet low in sodium chloride and saturated fats. Simple healthy habits will help not only not to be afraid of acute manifestations of hypertension, but also to correct it itself, and sometimes even completely eliminate it.

Success in the treatment of any pathology is determined not only by the innovativeness of medicines and the clinical experience of the doctor, but also by the patient's adequate attitude to his health and lifestyle.