Vascular crisis: symptoms and treatment
Recently, the subject of vascular disorders, in particular crises, has become more frequent.These states are devoted to considerable attention on the part of the medical profession, which is reflected in the modern understanding of these conditions.Table of contents: Etiology of vascular crises Classification of vascular crises Clinical variants of vascular crises Symptoms of vascular crises depending on types
Etiology of vascular crises
Vascular crises do not occur without certain conditions and conditions.Most often lead to them :
- Disturbance of the ratio of regulatory BAS, which have the greatest impact on vascular tone.To this group in the first place should be attributed: a group of catecholamines - adrenaline and norepinephrine;Mineralocorticoids - aldosterone;Serotonin, angiotensin, aurikulin.
- Structural changes in the walls of blood vessels.This category includes various disorders that lead to a violation of the elasticity of the tissues of the walls of the vessels, as well as the inability to respond adequately to standard chemical or physical factors.Most often they are associated with atherosclerotic changes, various metabolic disorders( including hereditary), diabetes mellitus, frostbite of the limbs, inflammatory diseases.
- Different types of endocrine pathology, as well as the body's response to hormonal changes in the body at certain periods of life - puberty and menopause.
- Defects of the cardiovascular system, both congenital and acquired - aorta coarctation, valvular heart disease with significant hemodynamic disorders.
- Pathology of peripheral and central nervous systems with impaired regulation of vascular tone.
- Pathology of peripheral vessels.
- Drug-related causes associated with improperly selected therapy, self-medication, disorder of prescribed regimens and dosages of drugs, as well as deliberate administration of pharmacological agents in high dosages.
- A separate group of diseases are combined, one of the clinical manifestations of which are symptoms associated with a vascular tone disorder - mainly: hypertension, as well as various types of symptomatic hypertension.
Are not, as such, the causes of crises, but critical changes in vascular tone are critical and life-threatening conditions, such as various types of shocks.
Important! The clinical manifestations of vascular crises are usually caused by several factors that enhance each other's actions.Sometimes it is extremely difficult to determine the exact leading cause, especially in the late stages of the disease, when many factors become equally weighty.
Classification of vascular crises
Initially, during the study of vascular crises as an independent disease, many approaches to classification were proposed.
The most common recently is the classification that separates the vascular crises into:
- Vascular systemic crises .For this group of hemodynamic disorders, manifestations associated with changes in vascular tone in all or most of the blood vessels of the whole organism are characteristic.Thus, with an increase in the overall resistance to peripheral blood flow due to spasm of small arteries, arterioles and capillaries, insufficient blood supply of all tissues occurs with a general increase in systemic arterial pressure-hypertension with the phenomena of relative heart failure( the cardiac muscle works with the load).With the fall of the general vascular resistance in combination with the deposition of blood in the venous bed with violations of the outflow of blood, there is a drop in blood pressure - hypotension.
- Vascular crises of a non-systemic nature. They are more often called regional or organ.In these cases, the main clinical manifestations are associated with the hyper- or hypotone of the vessels of one of any internal organ or limb.
Clinical variants of vascular crises
An extremely important point to pay special attention to is the rapid emergence of clinical manifestations.It can under certain circumstances be sufficiently pronounced and require medical assistance to the patient, often with subsequent hospitalization
Systemic crises options:
- crisis hypertensive
- crisis hypotonic( collapse);
- crises are vegetative-vascular.
Non-systemic crises options:
- cerebral crisis
Symptoms of vascular crises depending on the types
The clinical manifestation of vascular crises can be:
- hypertensive crisis;
- hypotonic crisis;
- vegetative-vascular crises;
- cerebral crisis;
Hypertensive crisisRecommended reading:
The hypertensive crisis is characterized by a significant rise in the values of systolic and diastolic blood pressure( extremely rare, in some diseases, only systolic pressure can be raised) with characteristic clinical manifestations.They include, first of all, a headache of a pulsating nature, more often in the occipital region, rhythmic noise in the ears, flickering of black dots in front of the eyes.
The skin of the neck and especially the face becomes flushed reddened with injected sclera.There are frequent hemorrhages in the sclera of one eye.Any movement, disturbances in this state lead to an increase in unpleasant sensations.Often there is nausea and vomiting, which does not bring relief to the patient, there may be trembling of the extremities or tremors, a feeling of lack of air, palpitation and pain in the heart.As a rule, the pain is blunt of average intensity.Patients tend to reduce physical activity, often sitting with their legs down.
Its main characteristic is a sharp drop in blood pressure values.These conditions are accompanied by severe dizziness, weakness and lightheadedness, mild nausea, which, however, seldom can end with vomiting.A person feels like "fails or loses consciousness."
There is always a profuse sweating tremor in the hands and feet.For a person, the change in the posture becomes characteristic: the standing person gently squats "crawls along the wall," and the sitting man lies down.A hypotonic vascular crisis is characterized by constant noise and ringing in the ears, a sharp pallor of the skin and constantly emerging sweat on the forehead.
Vegetovascular crises can be manifested as:
- Sympathetic-adrenal type of vascular crisis - occurs with a sharp increase in the activity of the sympathetic department of the central nervous system and an increase in the level of catecholamines, mainly adrenaline and norepinephrine.Such patients are nervous, restless, active.These crises are accompanied by a strong sense of anxiety and fear.Characterized by rapid heart rate - tachycardia, severe chills, headaches and discomfort in the chest.The limbs are dry and cold to the touch.
- The vago-insular type of vascular crisis is associated with the predominance of the influence of the parasympathetic department of the central nervous system.The main manifestations - profuse sweating, weakness, noise in the ears, increased intestinal peristalsis, marked nausea.From the heart - interruptions in the work of the heart.
- Hyperventilation type of vascular crisis - characterized by the fact that in response to a slight change in vascular tone there is an acute shortage of air, leading to significant dyspnea( tachypnea).Noisy often breathing quickly causes hyperventilation, tachycardia, sweating and a peculiar tetany - a strong spasm of the muscles of the upper limbs.
- Vegeto-vestibular type of vascular crisis - it is observed most often in the presence of pathology from the side of the central nervous system, such as: head trauma, ONMC, encephalopathy, and also for some types of ENT diseases.The main manifestations in this case are expressed dizziness, nausea, disruption of coordination of movements, often enough - the inability to walk and navigate in space.
In the vast majority of cases it develops against the background of atherosclerotic changes in the cerebral vessels and is accompanied by a sharp headache and vestibular disorders, nausea and multiple vomiting, dizziness, and impaired fine fine hand movement.Often this type of regional crisis accompanies excitement, dysmnesia or memory disorders, partial disorientation and general drowsiness with the persistent impossibility of a person falling asleep.
The sensitivity to sharp and loud sounds, as well as to bright light, increases significantly.In severe cases, patients try to be alone in a room with muted light, since a conventional speech, a working TV or radio, causes them a severe headache.
MigraineRecommended to read:
Migraine is characterized by a change in vascular tone from the initial spasm to enlargement.At the same time, a pronounced perivascular( perovascular) edema of the brain tissue was experimentally confirmed.Initially there is irritability, pulsating, and then a pronounced pressing headache, which always captures only half of the head - the so-called hemicranium.
AngioedemaWe recommend to read:
By its nature it is closely related to allergic pathology and is noted with the increased release of a large number of certain substances in the tissues, mainly serotonin.In this case, in some areas of the skin and mucous there is a swelling, an increase in the part of the body in size.
An important point that distinguishes this type of local vascular crisis is the absence of characteristic itching and discoloration of the skin or mucous membranes.
Angiotrophoneurosis is not a pure type of vascular crisis.From the side of the vessels for this condition is characterized by a fairly rapid change in spasm and enlargement in a specific area of the body.Usually the limbs suffer most, especially the fingers.Usually this is caused by a violation of innervation.
Emerging processes gradually become permanent, which quickly leads to dystrophic changes in tissues, which allows to consider such severe cases as separate diseases, including hereditary diseases - Raynaud's disease, systemic scleroderma.From these positions only the earliest stages can be attributed to angiotrophoneurotic local crises.
Treatment of vascular crises
Any type of vascular crisis, as an acute and sometimes serious condition, requires exceptionally qualified care.And to engage in self-medication( "the neighbor was the same and this helped her. ..") is unacceptable, inefficient, and sometimes just dangerous for health.
When conditions appear that resemble a vascular crisis for the first time, which, by the way, can often be at work and in public places, it is simply necessary to immediately call an ambulance.The doctor will examine you and provide the necessary therapeutic measures, after which he will decide the issue of your delivery to the hospital.
In a hospital or in a polyclinic, you need to undergo a comprehensive examination to find out what diseases you have, and the causes that lead to crises.This will help to select the appropriate treatment and choose the necessary recommendations, both in terms of course or maintenance therapy, and on taking drugs in "emergency cases."
Physician therapist, Sovinskaya Elena Nikolaevna