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Vascular crisis

Vascular crisis

Vascular crises are acute disorders of local blood flow and systemic hemodynamics. It can be hypotension of the veins, hypotension, or, conversely, hypertension of the arteries, as well as dysfunction of tissue arteriovenous anastomoses.

Vascular crises can be classified as follows: according to the prevalence of hemodynamic disorders, they are divided into systemic and regional. Systemic vascular crises manifest themselves in the form of changes that relate to the capacity of peripheral veins or general peripheral resistance to blood flow.

Regional vascular crises lead to a violation of the blood supply to an organ or tissue (that is, this violation is localized). To diagnose a vascular crisis, it is necessary to check whether the patient has symptoms of impaired general hemodynamics or regional hemodynamics, and also to exclude the presence of their connection with other pathologies of the heart or blood vessels.

In most cases, emergency medical care is required. The prevention of vascular crises corresponds to the prevention of the cardiovascular system. Prevention of recurrent vascular crises is based on the selection of an individual first-aid kit, the purpose of which is to prevent a recurrence of the crisis and to provide emergency assistance when it occurs.

The crisis is a pronounced manifestation of the disease. The development of crises is acute. They can be described as a seizure or attack. As a rule, this kind of condition requires the provision of emergency medical care to the patient. The term "crisis" itself is used to describe various pathological conditions.

Vascular tone disorders are the main cause of vascular crises. We are talking about a violation of the humoral and nervous regulation of vascular tone. The occurrence of vascular crises is possible with many diseases. These include, for example, hypertension, peripheral vascular and central nervous system pathologies. Vascular crises can occur in all diseases, the course of which is characterized by excessive flow of vasoactive substances into the vascular bed. These include, for example, the hormones adrenaline, serotonin, aldosterone, and others. The emergence of vascular crises can provoke vascular inflammation, frostbite, atherosclerosis - that is, everything that leads to a change in the receptor apparatus of the vessels and their walls (these changes are pathological). Violation of hemodynamics also refers to the causes of the development of vascular crises. In this case, we can talk, for example, about coarctation of the aorta. This means that in the area of ​​the isthmus of the aorta, its narrowing is observed. This disease is congenital.

Systemic and regional vascular crises can be distinguished. This classification is based on the prevalence of hemodynamic disorders.

Regional vascular crises correspond to a violation of the patient's blood supply to an organ or tissue. Thus, we are talking about a violation of the blood supply in a certain area of ​​the human body (these are localized blood supply disorders). In this case, arterial hypertension is manifested either by an almost complete cessation, or by a significant decrease in blood flow in a specific area. Arterial hypotension is manifested in excessive blood flow. Hypotension of the veins manifests itself as a localized violation of blood outflow. In the latter case, the blood stagnates in the capillaries and veins. The course of some types of diseases, such as migraine, Raynaud's disease, hypertension, is manifested by periodically recurring regional vascular crises. With migraine, attacks of hemicrania are possible (attacks of pain are localized in half of the head). Raynaud's disease is accompanied by recurrent attacks of ischemia of the fingers. The course of hypertension can be associated with cerebral vascular crises.

Systemic vascular crises manifest themselves as changes in the total capacity of peripheral veins or in the total peripheral resistance to blood flow (these changes are pathological). Systemic vascular crises are expressed in a fall or, conversely, an increase in blood pressure. With such crises, there are signs of secondary cardiac failure. Vascular crises, which are characterized by an acute drop in blood pressure, are subspecies of vascular collapse (pathogenetic variants). Vascular crises, which are associated with a sharp increase in blood pressure, are called hypertensive. Hypertensive vascular crises quite often occur with hypertension. In these cases, regional crises are combined with hypertensive crises.

Cerebral vascular crises usually occur in patients with arterial hypertension. Cerebral crises can also occur against the background of cerebral atherosclerosis. The onset of headaches can be described as sudden. These pains tend to get worse. They are combined with noise in the head or ears. In case of cerebral crisis, frequent manifestations are dizziness, impaired coordination of movements, a feeling of "black spots" before the eyes, nausea and vomiting, high blood pressure. In some patients with cerebral vascular crisis, symptoms of focal brain damage are observed. Such symptoms include impaired sensitivity, transient paralysis of the limbs, uneven tendon reflexes, and others. More rarely, with cerebral vascular crisis, drowsiness, disorientation in time and space, seizures, transient memory disorders, and psychomotor agitation occur.

Diagnosis of vascular crises is based on checking for the presence of symptoms of acute disorders of general hemodynamics or regional hemodynamics. The diagnosis of a vascular crisis is possible only after excluding the connection of these symptoms with organic pathology of the heart or blood vessels. In addition, with cerebral S. to. Hemorrhagic and ischemic strokes should be excluded, with hypertensive cardiac crisis - myocardial infarction (including according to ECG data), etc.

As a rule, treatment of vascular crises is urgent. The choice of medication is based on the type of vascular crisis. It is not so rare that a situation arises when an emergency hospitalization is necessary. If the appearance of vascular crises of one type in a patient is of a recurrent nature, then a specialist selects an individual set of medicines for him. Their purpose is to prevent a possible recurrence of a vascular crisis, as well as to provide emergency care when it occurs.


Watch the video: Hypertensive Crisis (December 2020).