Vascular crises

Vascular crises (crises angiodistonicheskie) - acute transient disorders of systemic hemodynamics or local blood flow caused by disorders of vascular tone, ie, hypertension or hypotension arterial hypotension veins, tissue dysfunction of arteriovenous anastomoses (AVA)... Observed in functional and organic pathology of the central nervous system, the endocrine system, hypertension and other diseases characterized by disorders of vascular tone regulation (including those due to excessive production of vasoactive substances - adrenaline, bradykinin, histamine, serotonin, and others.), With the defeat of most of the vascular wall and its receptor system (for example, by frostbite, atherosclerosis, vasculitis). Important in the pathogenesis of a change angiodystonia membranes of vascular smooth muscle function and the permeability of calcium channels. Vascular crises are divided into regional and systemic.

Regional crises correspond to localized disturbance of blood supply to an organ or tissue, depending on the type angiodystonia. Hypertension artery (artoriol), reaching sometimes vasoconstriction degree, characterized by tissue ischemia due to a sharp restriction or cessation of blood flow; hypotension arteries expressed by excessive inflow (hyperemia, local temperature rise, abnormal opening AVA - ischemic tissue with normal or increased inflow (phenomenon shunt "steal" capillaries); hypotension veins - they are overstretching of blood to local stagnation in the capillaries and pericapillary swelling of the tissue to the most. frequently encountered in clinical practice, a regional vascular crisis are cluster headache episodes in migraine and other forms of so-called vasomotor headache (see. cluster headache, migraine neuralgia, migraine), attacks the fingers ischemia disease and Raynaud's syndrome (see. Rebno disease), rodonalgia and reditsiviruyuschy akrotsianoz at angiotrofonevrozah so-called variant angina (caused by coronary artery spasm - see angina.), cerebral vascular crises in essential hypertension (see hypertensive crises.).

Systemic vascular crises are characterized by pathological changes in total peripheral resistance to blood flow (in systemic dysfunction and dystonia arteriod ABA) or the total capacity of the peripheral veins. They appear rise or fall in blood pressure and symptoms of secondary cardiac failure. Crises that occur with a sharp drop in blood pressure, considered among the pathogenetic variants of vascular collapse (see. Collapse). Crises with acute pathological increase in blood pressure is called hypertensive; they are often observed in hypertension, being combined with regional vascular crises (see. Hypertensive crises). Sudden rises in blood pressure are particularly common in disorders with hyperactivity of the sympathetic part of the nervous system, or (ii) release into the blood in excess of adrenaline, which leads to overstimulation adrenergic receptors of various organs. In these cases, vascular disorders are only part of the diverse manifestations of autonomic dysfunction or severe autonomic adrenergic crisis, often called sympathadrenalic or adrenal (depending on pathogenesis). Adrenergic crises observed in pheochromocytoma, hypothalamic syndrome and vegetative-vascular dysfunction of a different nature (see. Vegetative-vascular dystonia, diencephalic syndrome, pheochromocytoma).

Treatment of vascular crises in most cases should be urgent. The choice of drugs is determined by the pathogenesis of crisis (see. Vegetative-vascular dystonia, hypertensive crisis, Migraine). Patients with recurrent crises of the same type on the pathogenesis of selected means for their prevention and provide advice on acquisition and use of personal first aid kits.