Ischemic crisis - a condition in which blood circulation in the brain and heart muscle is disturbed. This is one of the options for cerebral hypertensive crisis. This condition is based on hypertensive pathology, or arterial hypertension. At risk are people in whom high blood pressure does not cause discomfort. And the crisis can come already when the blood pressure rises to 140/100.
Medics still cannot clearly answer why a crisis occurs, since such a violation has not yet been fully studied.
How to understand that an attack has begun?
Symptoms of an ischemic crisis are quite varied and non-specific. In some cases, they are considered as failures in the emotional state of a person. At the initial stage, as a rule, there is an increased excitability of the nervous system and increased energy, which was not previously observed.
In other patientsthere is, on the contrary, increased irritability, even aggressiveness, they can cry for no reason. Some people notice that tachycardia has begun, excessive sweating appears and a feeling of fear is tormented. Vomiting followed by nausea may begin.
In the future, the symptoms of an ischemic crisis completely depend on where the area is affected and the extent of the affected area. There may be "flies" before the eyes, a feeling of pressure in the eyeballs and other visual disturbances. Some patients have unsteady gait, they feel disoriented. Other patients suffer from a violation of the symmetry of the face, or there are problems with the articulation of the speech apparatus.
However, not all patients have open symptoms, it can be expressed only in subtle psycho-emotional disorders that only close people can notice.
Why is this happening?
The development of ischemic hypertensive crisis is associated with circulatory disorders. This condition is typical for stressful situations. It can also occur in people who are very sensitive to weather changes or to hypothermia, overheating. There are other reasons: food loads, physical overstrain, etc.
Even a large amount of alcoholic beverages can cause a crisis, overheating of the body or severe overwork. Individuals who are too addicted to s alty foods may suffer from a crisis. Long-term use of certain pharmaceutical drugs can causeattack. At the same time, such attacks are quite difficult to stop.
And of course, hypertensive patients who take antihypertensive drugs out of time are at risk. A crisis often occurs in women during menopause.
How is this happening?
Ischemic crisis always occurs suddenly. As a result of stress or other load, arteriole tone increases or cardiac output increases, and as a result, a rapid increase in blood pressure is observed. And this is the strongest load on the regional blood flow and the heart muscle.
Who is at risk?
In addition to hypertensive patients, an ischemic attack can occur in individuals with the following pathologies or problems:
- if the person is taking hormonal drugs;
- for alcohol lovers;
- for obesity;
- if there is a diagnosis of prostate adenoma in the anamnesis;
- for kidney problems;
- if there is a genetic predisposition.
People with circulatory or heart muscle disorders (cardiac asthma or coronary syndrome, coronary disease) are at risk.
Can there be an attack in childhood?
It is regrettable to admit, but children can also have an ischemic crisis. The reasons for this condition are the same as in the case of adults. If the baby has kidney failure, brain injury or intracranial hypertension, then it is quite possible that an attack will occur. Also at risk arechildren who have had type 2 hypertension.
Possible Complications
The condition of a person who has an ischemic crisis is characterized as very serious. Therefore, it is very important to diagnose the problem in time and take all measures that will stop the attack. In cases where an incorrect diagnosis was made or first aid was not provided, the following complications may occur:
- thrombosis;
- azotemia;
- pulmonary edema;
- kidney failure;
- arterial embolism.
If the heart muscle is damaged as a result of an attack, arrhythmia or tachycardia may develop.
How is the diagnosis made?
It is clear that at the very beginning of an attack, it is necessary to take all measures that will reduce the manifestations of the crisis. Especially if everything happened on the street or at home, where it is impossible to understand exactly what is happening to a person.
If the crisis occurred in the hospital, then with the simultaneous measurement and decrease in blood pressure, complaints are clarified. The doctor assesses the general condition of the patient, checks tendon reflexes, auscultates the heart muscle and lungs. An MRI of the brain, electrocardiography, ultrasound diagnostics of blood vessels can be performed.
After stopping the attack, the patient must be sent to specialized specialists: an ophthalmologist and a neurologist to assess the state of he alth of individual organs.
Prognosis for recovery
Ischemic crisis on the background of high blood pressure can cause death. If aall measures to stop the attack are taken in time, then the probability of positive results from drug therapy is very high.
Unfavorable prognosis can be in the following cases:
- late diagnosis;
- huge chance that after an attack there will be complications that are life-threatening.
First Aid
If a person becomes ill, then he needs to provide a half-sitting position. Pillows can be placed under the head. Further, emergency care for an ischemic crisis is to give the patient drugs that reduce high blood pressure. If the patient has previously taken any drugs, they helped him, then they must be given, but in the dosage recommended by the doctor. In particular, it can be Corinfar or Kapoten. To normalize the work of the nervous system, you can give "Valocordin" or "Corvalol".
Of course, if the pressure cannot be reduced in any way, then you must immediately call an ambulance.
What to do if no one was around?
A person who feels that he has a stroke should immediately lie down and try to relax. It is necessary to take a few breaths and exhalations, take a pill for high blood pressure.
Treatment of an ischemic crisis can be carried out with drugs that are used on an ongoing basis, Captopril, Klaforan and others are also often used. If the drugs did not help and the pressure does not decrease byfor 30 minutes, you should immediately dial the phone number 03.
In cases where it was possible to stabilize the condition, you should not relax, you must definitely visit a doctor and tell about the incident. You may need to adjust the dosage of the drug you are taking or change it to another one. We should never forget that hypertensive patients need to regularly measure their pressure in order to prevent a stroke in time.
Treatment measures
A fairly wide range of drugs is presented on the pharmaceutical market. An ischemic crisis is a fairly common phenomenon, so not only emergency doctors, but also clinicians know how to stop it. It is advisable to know the basics of first aid for the patient and his relatives.
Clonidine
This is a classic remedy for a crisis. It is a very powerful blood pressure lowering agent, so it should be used with great care. It is drugs containing clonidine that reduce pressure so quickly that they can cause collapse. In light of this, drugs of this group are used only in a hospital, when the patient is in a horizontal position. There are two forms of release: solution for intravenous administration and tablets under the tongue.
Beta blockers
Means from this group are designed to expand the lumen of the arteries, slow down the heartbeat. This type of action occurs throughblocking adrenoreceptors on the walls of arteries and heart muscle.
From this group, the most popular are: Inderal, Metoprolol, Labetalol, Anaprilin.
Calcium blockers
Drugs from this group are widely used in therapy aimed at eliminating cardiac arrhythmias and lowering blood pressure. Let's consider one of them in more detail.
"Nifedipine": instructions for use, at what pressure should it be taken?
This drug has been known since the times of the Soviet Union, and its popularity has not decreased over the years. The drug allows you to slow down the rate of passage of calcium ions to the vessels of the heart. As a result, the lumen in the vessels increases and blood pressure decreases. In addition, the drug normalizes the heart rhythm and reduces the load on the heart.
However, the longer the drug is taken, the less effective it is, as indicated in the instructions for use of Nifedipine. At what pressure should it be taken? The drug is indicated for use in cases where the pressure increases the rate by at least 20-25%. Already at this level, almost immediately, after 5-30 minutes, the effect of taking it appears.
This medicine has contraindications. It is forbidden to use if there is tachycardia, there was a heart attack 8 days ago, there is decompensated heart failure. Prohibited medicine for use during pregnancy and lactation.
During an attack, depending on the severity of the symptoms, from 0.25 to 10 mg per kilogram of the patient's weight is prescribed.
ACE Inhibitors
Drugs of this group are most often used to treat hypertension, but can also be used to relieve a crisis. Such tablets dissolve at the time of the onset of an attack. The drugs in this group include Enap or Enam.
Medications that relax smooth muscles
In fact, these are drugs that have a muscle relaxant effect. It is thanks to this quality that the lumen expands and, as a result, blood pressure decreases. In fact, this is one drug - "Dibazol", which is quite often used in therapy along with papaverine.
Diuretics
The most commonly used are loop diuretics. It is these drugs that have an almost instant effect. The most commonly used is Furosemide.
The main quality of these drugs is that they can be used at any time, and to increase the effect, you just need to increase the dosage.
Nitrates
This range of medicines is often used to treat coronary disease. When stopping a crisis, the following drugs are used: "Naniprus" or "Niprid", that is, those where the active ingredient is sodium nitroprusside.
Drugs are administered intravenously, drip. Depending on the condition of the patient, the dose may be from 0.25 to 10 milligrams per kilogram of body weight.
Peculiarities of crisis assistance
To stop the crisis as quickly as possible, drugs are administered intravenously or are given to dissolve under the tongue. This is due to the fact that very often in this condition in patients observednausea, which does not allow taking drugs orally. Moreover, after taking the tablet, the drug is absorbed for a long time in the gastrointestinal tract. Also, against the background of an attack, a narrowing of small arteries is observed, namely, they should participate in the process of absorption into the bloodstream. If the tablet dissolves, then the active substance is absorbed not only through the blood, but also through the mucous membrane, hence such a quick effect.
As a rule, drugs from different groups are used in combination to achieve positive dynamics as quickly as possible and avoid the complications of a crisis.
What to do after an attack?
First of all, the patient will have to constantly monitor blood pressure, and this procedure is shown for life. You will have to use medication to reduce pressure throughout your life.
Stressful situations should be avoided as much as possible. Remove heavy physical activity from your life. Only sports should be present, but in moderation and not too strenuous, it can be yoga, gymnastics.
You'll have to stop smoking and drinking alcohol. Under no circumstances should you be obese. On an ongoing basis, it is necessary to maintain the water balance at the proper level, that is, consume at least 1.5 liters of water per day. It is necessary to abandon harmful foods, fried and fatty foods. The diet should contain fiber, cereals, vegetables and fruits.
Every person who survivedischemic stroke, must adhere to these rules, in order to prevent its recurrence, visit the doctor regularly.
