Crises are pronounced, intense manifestations of the disease, developing acutely in the form of a so-called attack or seizure, in which, as a rule, there is a need for emergency care. The term “crisis” is used in a variety of pathological conditions.
Vascular crises (angiodystonic crises) are acute transient disorders of systemic hemodynamics or local blood flow caused by disorders of vascular tone, that is, hypertension or hypotension of the arteries, hypotension of the veins, dysfunction of tissue arteriovenous anastomoses.
Causes of vascular crises
The cause of vascular crises are violations of the nervous and humoral regulation of vascular tone. Vascular crises are observed with the following disorders:
- pathology of the central nervous system
- pathologies of peripheral vessels
- dysfunction of the adrenal glands, thyroid and other endocrine glands
- with hypertension
- diseases accompanied by excessive release into the vascular bed of various vasoactive substances – adrenaline, aldosterone (a hormone produced in the adrenal cortex that regulates mineral metabolism in the body), serotonin (as a hormone, serotonin regulates the motility of the gastrointestinal tract, mucus secretion, causes spasm of damaged vessels etc.), histamine (for example, in allergic reactions), bradykinin, etc.
Varieties of vascular crises
According to the prevalence of hemodynamic disorders, vascular crises are divided into regional and systemic.
Regional crises correspond to localized disorders of the blood supply to an organ or tissue, depending on the type of angiodystonia (vascular disorders in the intestinal walls).
Hypertension of the artery (artoriol), sometimes reaching the degree of angiospasm, is characterized by tissue ischemia due to a sharp restriction or cessation of blood flow. Arterial hypotension is expressed by excessive blood flow; hypotension of the veins – their overstretching, local stagnation of blood in the capillaries and pericapillary tissue edema.
Systemic vascular crises are characterized by pathological changes in the total peripheral resistance to blood flow or the total capacity of the peripheral veins. They are manifested by an increase or decrease in blood pressure and signs of secondary cardiac failure. Crises occurring with an acute drop in blood pressure are considered among the pathogenetic variants of vascular collapse. Crises with an acute pathological increase in blood pressure are called hypertensive; they are often observed in hypertensive disease, combined with regional vascular crises.
Treatment of vascular crises
In most cases, it should be urgent. The choice of drugs is determined by the pathogenesis of the crisis. A patient with recurrent crises of the same type in terms of pathogenesis is selected for their prevention and given recommendations on the acquisition and use of an individual first aid kit.