I thisen sang chu a sang nghal em? Hypertensive crisis chungchang hi i zir dawn teh ang!

Mi pakhatin rang takin thisen sang tak a nei a, damdawi inah hruai nghal a ni tih i hre ngai em? A nih loh leh chutiang thil chu i tawng ve tawh em? Hei hi damdawi lama kan sawi thin chu hypertensive crisis emaw ``Hypertensive Crisis'' emaw a ni. Hei hi thil tenawm tak a ni lo va, nunna atana hlauhawm thei a nih avangin. Chuvangin, he thu hi chiang takin sawi ila.

He hypertensive crisis hi eng nge ni?

A awlsam zawngin, hei hian i thisen sang chu a sang hle thut tihna a ni. Tunah chuan mi hrisel thisen sang hi eng ang nge a nih tur tih hi han thlir ila:

• Upper value (systolic pressure) : mercury millimeter 120 aia tlem (120 mm Hg) a ni.
• A value hniam zawk (diastolic pressure) : mercury millimeter 80 aia tlem (80 mm Hg) .

Mahse, he hypertensive crisis lai hian i thisen sang chu hetiang hian a lo awm ta a ni:

• Upper value : 180 mm Hg aia tam, leh/ emaw
• A hniam zawk : 120 mm Hg aia tam.

Hei hi medical emergency a ni ! I thisen sang hian heng level te hi a thlen chuan emergency room (ER) ah i kal nghal tur a ni.

A tam zawkah chuan hetiang harsatna hi thisen sang (hypertension) nei tawhte zingah a thleng thin. Chu chu nitin nunah pawh an pressure chu a pangngai aia sang a ni tihna a ni. Mithiamte sawi dan chuan thisen sang nei zinga 1% atanga 2% inkar velin he harsatna hi an nei thei a ni. Mahse, hetiang dinhmun hi pressure lama harsatna nei ngai lote zingah pawh a awm thei tih hriat reng a pawimawh.

Hei hi chi hnih lian tak a ni.

Hypertensive crise hi chi hnih ah then theih a ni a:

1. Hypertensive urgency : Hetiang a nih chuan i thisen sang a sang hle a, mahse i chhungril peng (i thinlung, thluak, kal ang chi) tihchhiatna chhinchhiahna a awm lo. Doctor thenkhat chuan hei hi "uncontrolled hypertension" an ti bawk. A hming chu eng pawh ni se, a pawimawh ber chu a rang thei ang bera i thisen sang chu a pangngaia awm leh hi a ni.

2. Hypertensive emergency : Hei hi a hlauhawm ber a ni. Hetah hian i thisen sang a sang lutuk a, i chhungril taksa peng hrang hrangah chhiatna thar a thlen a, a nih loh leh chhiatna awmsa chu a tizual sauh sauh a ni. Entirnan, taksa peng hrang hrang, thinlung, aorta, mit, thluak, kal (kidney) te hi a chhe thei hle. Hmeichhe naupai zingah preeclampsia na tak leh eclampsia te pawh he category-ah hian an tel ve bawk.

"Maligant hypertension" tih thumal hi i hre tawh mai thei. Kum zabi 20-na tir lama hman \hin thumal a ni. Thisen sang nghal vanga kal leh mit tihchhiat tihna a ni. Doctor thenkhat chuan "hypertensive emergency" chungchang an sawi hian he thumal hi an la hmang reng a ni. Mahse tunah chuan "hypertensive emergency" tih hi a awmzia chiang zawk a neih avangin hman a ni ta zawk a ni.

He hypertensive crisis hi engte nge a lan chhuah?

Symptoms chu internal organs a chhiat leh chhiat lohah a innghat.

Hypertensive urgency (organs tihchhiat loha thisen sang sang) .

A tam zawkah chuan symptom lian tham a awm lo. I thisen sang lutuk leh sang lutuk hriat theihna awmchhun chu teh tir hi a ni. Mahse, a chang chuan symptoms te hi i nei thei a:

• Hlauhna leh lungawi lohna (Anxiety) .
• Lu na deuh
• Hnar thisen tlem a chhuak
• Thâwk harsa deuh

Hypertensive emergency (thisen sang leh taksa peng hrang hrang tihchhiatna) .

Hetiang a nih chuan taksa chhunga taksa peng hrang hrangte a chhiat avangin a natna lan chhuah dan a na hle.

• Rilru dinhmun danglam , buaithlak tih hriat
• Chhuak na emaw, rilru a tight tih hriatna emaw
• Luak chhuak thei
• A hring, a bik takin ke (edema) .
• Lung na tak tak
• A tlangpui aia zun chhuah tlem zawk
• Seizures a awm thin
• Lu na na tak, tuar theih loh
• Stroke symptoms : Entirnan, hmai sir khata tlak thut, tawngkam mumal lo, kut emaw ke emaw (a sir khatah) chakna hloh nghal emaw.
• Mit a inthlak : Mit a na, mit a tlakchham thut, emaw, mit a fiah lo.

Doctor-in a enfiah che hian heng ang chhinchhiahnate hi an zawng thei bawk ang:

• Jugular venous tihzauh a ni
• Lung lam ngaihthlak laiin thawm pangngai lo (crackling) hriat
• Thinlung ri thar, danglam tak, a hmaa awm ngai lo (thinlung murmurs) .
• Mit chhunga thisen kalna kawng (retinal membrane) tihchhiat .
• Stroke rinhlelhna siamtu chak lohna danglam tak, asymmetric

Eng thilin nge he hypertensive crisis hi a thlen?

Hei hi chhan hrang hrang a awm a:

• A chhan langsar ber chu i thisen sang damdawi i ei dik loh vang a ni a, i doctor-in a tih ang leh a hun taka i ei loh vang a ni. Hei hi chhan hrang hrang (theihnghilh, damdawi tlakchham, tumruh taka ei loh) vangin a thleng thei.
• Thisen sang damdawi ei khap nghal mai.
• Damdawi pakhat i ei hian damdawi dang (drug interaction) nen a inzawm thei a ni.
• Kal natna.
• Endocrine lam thil (hormonal chungchang) a awm.
• Preeclampsia emaw eclampsia emaw hi naupai laiin thisen sang, thisen sang a ni.
• Ruihhlo ngawlvei (drugs) thenkhat hman.
• Lu hliam na tak (Head trauma).
• Thluak natna (brain tumor) a ni.
• Damdawi thenkhat natna dang i ei thin.

Hypertensive crisis thlen thei damdawi chi hrang hrang a awm a:

• Steroid chi hrang hrang
• Depression damdawi thenkhat
• Cyclosporine a ni
• Pseudoephedrine, khawsik leh flu damdawi thenkhata tel

Tute nge hetiang hi vei theihna hlauhawm zawk?

Hetiang natna hi i vei theihna chance a sang zawk thei a, chu chu:

• I body mass index a san chuan i thau tihna a ni .
• Mipa i nih chuan .
• International study thenkhatah chuan African hnam chhuakte chu an hlauhawmna a sang zawk tih hmuhchhuah a ni. Mahse, he dinhmun hian tu pawh, eng chi pawh a nghawng thei tih hre reng ang che.
• I thisen sang damdawi a hun taka ei lo mi i nih chuan .
• Doctor-in a pek loh damdawi (e.g. cocaine, amphetamines) i hman chuan.

Hei hian eng harsatna hlauhawm nge a thlen theih?

Chutianga pressure hlauhawm taka a san chuan harsatna lian tak tak a thlen thei a, chungte chu:

• Lung chak lohna rang tak (acute heart failure) .
• Lung chhunga tuiin a khat nghal (acute pulmonary edema) .
• Kidney function hloh nghal (acute kidney failure) .
• I taksaa thisen kalna kawng lian ber (aorta) a tikehsawm emaw, a puak emaw (aortic dissection) .
• Thluak chhunga thisen chhuak (intracranial hemorrhage) .
• Heart attack hi thinlunga thisen kal tlem vang a ni.
• Ischemic stroke hi thluaka thisen kal tlem vang a ni.
• Hun engemaw chen thluak hnathawh that lohna (hypertensive encephalopathy) .

Heng zawng zawng hi nunna atana hlauhawm a ni thei. Chuvang chuan i thisen sangah fimkhur turin kan ti a ni.

Engtin nge doctor-te hian he natna hi an hriat theih?

Doctor chuan i kut pahnih atanga i thisen sang a teh hmasa ang a, hypertensive crisis i nei em tih a hriat theih nan. Chu bâkah, i damdawi lam chanchin kimchang (natna hmasa leh damdawi i ei tawh ang chi) a zawt ang a, i natna lan chhuah dânte a sawipui ang che a, taksa enfiahna kimchang a nei ang. A chhan hriat theih nan test dang eng emaw zat a ngai mai thei.

Test tih theih chi hrang hrang:

• Thisen test (kidney function leh salt level ang chi thil enfiah nan) .
• Zun test a ni
• Thinlung electrical activity enfiahtu ``EKG/ECG'' strip a ni
• Fundoscopic exam (mit chhunga thisen kalna kawng a chhiat leh chhiat loh enfiah nan) .
• Neurological exam a ni
• Thinlung ultrasound scan (`Transthoracic echocardiogram`) hmanga enfiah a ni.
• Chhung leh lu CT scan

I chhungril taksa peng hrang hrang tihchhiat thar chhinchhiahna a awm chuan doctor chuan ``hypertensive emergency'' a ti ang a, chutiang chhinchhiahna a awm loh chuan ``hypertensive urgency'' a ni ang.

He hypertensive crisis hi engtin nge enkawl a nih?

Hei hi damdawi in emergency room ah enkawl a ni . Doctor-te chuan damdawi an pe ang che a, i thisen sang chu a him tawkin a tihhniam ang che.

• Internal organ chhiatna (i.e., hypertensive urgency) chhinchhiahna i neih loh chuan chu ni vek chuan i haw thei mai thei. Mahse in lama ei tur damdawi engemaw zat nen in lamah an thawn haw ang che.
• Mahse, ``hypertensive emergency`` (organ damage) i neih chuan damdawi in intensive care unit (ICU) -ah ni engemaw zat i awm a ngai dawn a ni. Chutah chuan doctor-te chuan thisen kalna (IV) damdawi an pe ang che a, i thisen sang chu an enfiah chhunzawm zel ang.

I medical team chuan engtiang chiahin nge i thisen sang tihhniam a ngaih tih an rel ang. I damdawi lam dinhmun dang i neih danah a innghat ang. A châng chuan i thisen sang tihhniam thuai chuan i taksa peng leh taksa peng hrang hrangte thisen kal a tichhe thei tih hre reng ang che. Chuvangin, i thisen sang tihhniam nan darkar 24 atanga 48 vel a ngai tlangpui.

Mahse, natna bik, aortic dissection, severe preeclampsia, emaw eclampsia emaw i neih chuan doctor-te chuan i thisen sang chu an tihhniam thuai ang. Chutiang hunah chuan, i thisen sang tihhniam thuai chuan a hlawkna chu a hlauhawmna tenau tak takte aiin a tam zawk daih a ni.

Hemi atana damdawi hman \henkhat chu `(Captopril)`, `(Clevidipine)`, `(Clonidine)`, `(Esmolol)`, `(Hydralazine)`, `(Labetalol)`, `(Nicardipine)`, `(Nifedipine)`, `(Nitroglycerin)` leh `(Nitroprusside)` te an ni. I doctor chuan i dinhmun, damdawi dang i ei leh i hriselna zawng zawng a zirin i tana tha ber tur damdawi a thlang ang.

Engtikah nge Doctor ka hmuh ang?

I thisen sang 180/120 mm Hg aia sang a nih chuan 1990 (emergency number) call nghal la, emergency room hnai ber pan rawh. Enkawlna hmanhmawhthlak i mamawh!

Hetiang thisen sang harsatna i neih hnu hian i chhungkaw doctor pangngai hnenah i hmu ang. I thisen sang damdawi dose thlak emaw, damdawi thar dah belh emaw a tum mai thei. I nitin nunah inthlak danglamna i neih tur (ei leh in leh exercise ang chi) chungchang pawh a sawipui ang che. Entirnan, chi tlem leh thei leh thlai tamna ei tur (`DASH diet` ang chi) ei tur leh nitin exercise la turin an fuih thei che a ni.

Hetiang dinhmun hi a lo awm a nih chuan eng nge ka beisei ang?

Hypertensive crisis hi i thisen sang control tha lo tih hriattirna pawi tak a ni. I doctor hian i thisen sang tihhniam nan leh hrisel level-a dah turin a pui thei che a ni. A pawimawh ber chu i appointment te vawng reng tur leh i damdawi te chu a pek ang chiah chiah ei tur a ni.

"Crisis" tih thumal i hriat hian hlauhna leh lungkhamna i neih hi thil pangngai a ni. I ngaihtuah mai thei, "Hetiang hian ka thisen sang a sang leh dawn em ni?" A nih loh leh, "He thisen sang harsatna hian engtin nge ka hriselna leh ka hmalam hun a nghawng ang?"

Ngaihtuah teh, hetiang taka i thisen sang a san theihna chhan tam tak a awm. Doctor-te chuan mi tinte tana a chhan bikte chu eng nge ni tih hriat tumin hma an la mek a ni. A chhan dik tak i hriat hnuah, chutiang harsatna lo thleng leh theihna tur tihtlem nan hma i la thei ang.

Hei hian i phone-ah i damdawi ei tur hriattirna tur hriattirna i siam tihna a ni thei. A nih loh leh, i doctor nen damdawi dang i ei tur chungchang sawipui a, a tul chuan siamthat tihna a ni thei bawk. Tuna i thisen sang control nâna i hmalakna tê tê apiang hian nakin lawka hrisêlna lama harsatna lian tak i neih theihna tûr tihtlem nân kawng thui tak a zawh thei tih hre reng ang che.

A tawp berah chuan hriat reng tur pawimawh ber ber (Take-Home Message) .

• I thisen sang value hre rawh: I thisen sang pangngai chu eng nge ni? Emergency (180/120 mm Hg aia sang) chu eng nge ni tih chiang takin hria ang che.
• I damdawi ei dik: I doctor-in i thisen sang damdawi a pe che a nih chuan a hun takah leh a zat dik takah ei ngei ngei tur a ni. Ni khat pawh skip suh.
• Vaukhânna chhinchhiahnate chu hre rawh: Lu na nasa tak, rilru na, thawk harsa, mit hmuhna danglam, thusawi thiam loh, emaw, ke ruh hloh emaw ang chi chhinchhiahna i neih chuan natna khirh tak a ni thei.
• Damdawi lam thurawn zawng nghal rawh: A chunga kan sawi ang chite hi i neih chuan, emaw, i thisen sang 180/120 mm Hg aia sang a nih chuan hun khawhral suh la, doctor thurawn la nghal rawh. Damdawi inah kal la, 1990 ah call rawh.
• Nunphung tihdanglam: Ei leh in hrisel (chi, hriak, leh sugar tlem), exercise neih fo te , zu in loh te, zu in tlem te hian i thisen sang control-na kawngah kawng thui tak a zawh thei a ni.

He thu hi i tan a tangkai ngei ka beisei. I hriselna chu i kutah a awm tih hre reng ang che. Uluk takin enkawl rawh!

` Thisen sang, pressure, emergency, thisen sang harsatna, symptoms, enkawl dan, thinlung natna