Signs & Symptoms of a Hypertensive Crisis
- People who have problems with high blood pressure should be aware of the complications of a sudden, sharp increase in their blood pressure leading to a hypertensive crisis. Blood pressure above 180/110, called Stage 3 hypertension, can inflame blood vessels, causing them to leak blood. This can lead to dangerous complications, including a stroke or heart attack.
A person experiencing Stage 3 hypertension should see a doctor immediately. Quick, accurate diagnosis and immediate, proper treatment can save a patient's life; it can also mean the difference between permanent disability and recovery. - A bad headache, shortness of breath, severe anxiety, papilledema (in which the head of the optic nerve swells), and pedal endema (accumulation of fluids in the feet) are all symptoms of an urgent hypertensive crisis. Blood pressure at the urgent level does not damage body organs; physicians can use medications to lower blood pressure to safe levels within hours. An urgent hypertensive crisis can be treated outside the hospital without intravenous drugs, but patients need follow-up and medical supervision.
An urgent hypertensive episode can develop over days or even weeks. The causes ordinarily include uncontrolled high blood pressure increasing pressure in the brain, hypertension before and after surgery, and disease of the coronary arteries. - High blood pressure that is actively damaging organs or about to harm them signals an emergency hypertensive crisis. Among the signs and symptoms of an emergency crisis are angina (chest pain), swollen or bleeding eyes, dyspnea (shortness of breath), anxiety, severe headaches, and seizures.
The emergency crisis patient should be admitted at once to an intensive care unit. Physicians can inject vasodilating drugs (drugs that widen blood vessels) to reduce the blood pressure slowly and safely. But physicians have to be careful: hypoperfusion, a sudden reduction in blood pressure, can damage veins and arteries in the brain and heart, cause kidney problems and retinal arterial occlusion (closing of the eye's central artery) leading to blindness.
Physicians and staff should continuously monitor the patient's blood pressure.
An emergency hypertensive crisis shows numerous life-threatening symptoms including bleeding in the brain (stroke) and acute myocardial infarction (heart attack). They may also include pulmonary edema (fluid in the lungs), eclampsia (convulsions) in pregnant women, brain edema (swelling or bleeding of the brain), and aortic dissection (a tear in the major artery that carries blood from the heart).
A emergency crisis can also cause an aneurysm (a bulge in a blood vessel), acute failure of the left ventricular (the main chamber of the heart), hypertensive encephalopathy (brain damage), encephalopathy (confusion or coma), a subarchnoid hemorrage (blood collecting under the membrane surrounding the brain) or intracerebral hemorrhage (a blood vessel bursts in the brain). - Surgery can trigger a hypertensive crisis. So can undetected worsening of existing high blood pressure. Eating too much salt can set it off. Other contributors include withdrawing from alcohol abuse, neurological conditions, over-the counter preparations that contain pseudoephedrine, plus using cocaine and other illegal drugs.
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