I thisen sang chu a sang chho nghal em? Hypertensive Crisis chungchang hi han sawi ila!

I thisen sang, a nih loh leh kan hriat vek angin "pressure" kha a sang lutuk nghal a nih chuan eng nge thleng ang tih i ngaihtuah ngai em? A châng chuan i lu a buai thei a, i rilruah thil mak tak a awm thei bawk. Hei hi vawiin a kan sawi tur dinhmun, hypertensive crisis an tih chu a ni. Hei hi dinhmun pawi tak a nih avangin kan tih tur dik tak kan hriat a pawimawh hle.

Hypertensive crisis tih hi eng nge ni? A dik chiahin i chhui chhuak ang u!

A awlsam zawngin sawi ila, hypertensive crisis chu i thisen sang a san nghal lutuk hi a ni. Tunah chuan, "I thisen sang pangngai chu eng ang nge ni tur?" I han en teh ang.

Mi hrisel thisen sang pangngai chu hetiang hi a ni tur a ni.

• A chunglam number (systolic pressure) : chu mercury millimeter 120 (mm Hg) aia tlem a ni tur a ni.
• Value hniam zawk (diastolic pressure) : Mercury millimeter 80 aia tlem (mm Hg) a ni tur a ni.

Mahse, ``Hypertensive Crisis'' lai hian heng zat hi ngaihtuah phak loh khawpin an pung a:

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

Hei hi hriat reng tur a ni: Thisen sang hi medical emergency a ni. Chumi awmzia chu i thisen sangin hetiang level a thlen chuan damdawi in emergency room-ah i kal nghal tur a ni.

A tam zawkah chuan hetiang emergency hi thisen sang (hypertension) vei te zingah a thleng thin. Chumi awmzia chu an thisen sang chu a pangngai aia sang reng reng tihna a ni. Mithiamte sawi dan chuan thisen sang nei zinga 1% leh 2% inkar chuan ``Hypertensive Crisis'' an tawk thei a ni. Mahse, mak tak maiin, he natna hi thisen sang lama harsatna nei ngai lo tan pawh a awm thei a ni.

Hei hi chi hnih lian tak a awm a ni lawm ni? Eng nge an nih?

Ni e, he `(Hypertensive Crisis)` hi chi hnih lian tak a awm. Chu chu chipchiar deuhin han sawi ila .

1. Hypertensive hmanhmawhthlakna:

Hei hi i thisen sang lutuk, a hmaa kan sawi tawh 180/120 mm Hg aia sang thlenga a san chuan a ni. Mahse, a pawimawh ber chu i chhungril taksa peng hrang hrangah chhiatna a awm lo. Doctor thenkhat chuan hei hi ``Hypertensive Urgency'' ti lovin ``uncontrolled hypertension'' an ti a. Chuvangin, a hming chu eng pawh ni se, hetah hian a pawimawh ber chu i pressure chu rang taka hriselna level-a hruai kir leh hi a ni.

2. Hypertensive Emergency-a awm tur chuan:

Hei hi chi hlauhawm ber a ni. I thisen sang pawh a sang nasa hle a, mahse i taksa peng hrang hrangah chhiatna thar a thlen bawk a, a nih loh leh chhiatna awmsa a tizual bawk.Ngaihtuah teh, hei hian i thinlung, aorta, mit, thluak, leh kal ang chi taksa peng pawimawh tak takte a tichhe thei a ni. Nu naupai zinga preeclampsia na tak leh eclampsia ang chi dinhmun pawh hi he ``Hypertensive Emergency'' category-ah hian a tel a ni.

"Malignant Hypertension" tih thumal hi i hre tawh mai thei. A nihna takah chuan kum zabi 20-na tir lama hman thin thumal hlui a ni. Chu chu thisen sang sang tak, nasa taka sang tak, kal leh mit tichhe thei tihna a ni. Doctor thenkhat chuan "Hypertensive Emergency" chungchang an sawi hian "Hypertensive Emergency" tih thumal hi an la hmang reng a ni. Mahse, tunlai doctor-te chuan "Hypertensive Emergency" tih hi hman an duh zawk a, a chhan chu tunlai hian hrilhfiahna chiang zawk a neih vang a ni.

Eng symptoms awm thei nge ni? Engtin nge i hriat chian?

``Hypertensive Crisis'' chhinchhiahna chu a hmaa kan sawi tawh ang khan taksa peng hrang hrangte a chhiat leh chhiat lohah a innghat a ni.

Hypertensive Urgency (a awmzia chu, taksa peng tichhe lova pressure a san lutuk chuan) hian symptom a nei lo fo thin. I thisen sang lutuk leh sang lutuk hriat theihna awmchhun chu teh tir hi a ni. Mahse, a chang chuan hetiang symptom hi i nei thei a ni:

• Hrisel lohna leh hlauhna (Anxiety) .
• Lu na deuh a ni.
• Hnar atanga thisen chhuak
• Thâwk harsa deuh

Hypertensive emergency (chu chu pressure-in taksa peng a tihchhiat hunah) a lan chhuah dan chu a na zawk a, chungte chu:

• Rilru dinhmun inthlak danglam (lungkhamna, buai) .
• A rilru a na
• Luak chhuak (vertigo) .
• Taksa a hring (Edema) .
• Lung na tak tak
• A tlangpui aia zun chhuah tlem zawk
• Convulsions (convulsive state, fit ang chi) 1.1.
• Lu na na tak a ni.
• Paralysis symptoms (entir nan, hmai sir khat tlak nghal, tawng harsa, kut leh/ emaw ke chak lohna) .
• Mit a inthlak danglam (mit na, mit hmuhna hloh, mitdel nghal mai ang chi) .

Doctor-in a enfiah che chuan ``Hypertensive Emergency''-ah hetiang symptom hi i hmu thei ang:

• Jugular venous tihzauh a ni
• Lung ngaihthlak hian crackling sound a awm thin
• A hmaa awm lo thinlung ri pangngai lo (heart murmurs) .
• Mit hnung lama thisen kalna kawng a chhiat chhinchhiahna
• Thil danglam tak, asymmetrical weakness, paralytic condition rinhlelh awm

Engvangin nge hetiang dinhmun hi a lo awm? A chhan engte nge ni?

Hetiang ``Hypertensive Crisis`` a lo awm theih chhan hi chhan hrang hrang a awm thei. A bulpui berte han thlir ila:

• A chhan langsar ber chu i thisen sang damdawi i ei loh vang leh a tih ang taka i ei loh vang a ni. Eng thil vang pawha i dose i miss a nih chuan hetiang hi a thleng thei tihna a ni.
• Thisen sang atana hman damdawi tihtawp nghal.
• Damdawi dang i ei mek nena inzawm.
• Kal natna.
• Endocrine chungchang a ni.
• Naupai laiin preeclampsia emaw eclampsia emaw a awm thin.
• Ruihhlo ngawlvei thenkhat hman.
• Lu hliam (lu hliam).
• Thluak natna (brain tumor) a awm.
• Damdawi thenkhat chu condition dang atan i ei thin.

``Hypertensive Crisis'' thlen thei damdawi thenkhat chu:

• Steroid chi hrang hrang
• Depression damdawi thenkhat
• Cyclosporine a ni
• Pseudoephedrine, khawsik leh flu damdawi thenkhatah a awm

Tute nge risk sang zawk? (Risk Factor hrang hrang) 1.1.

Mi thenkhat chu midang aiin ``Hypertensive Crisis'' an neih theihna chance a sang zawk. Tute nge an nih i en ang u:

• Thau lutuk nei tan.
• Mipa tan chuan.
• Mihring dum tan (hei hi genetic leh socioeconomic factors atanga lo chhuak a ni thei).
• Thisen sang damdawi pek hi a hmang reng lo tan chuan a tha hle.
• Doctor prescription tel lova stimulant drugs hmangtute tan.

Hei hian eng harsatna hlauhawm nge a thlen theih?

Hetiang level hlauhawm takah hian pressure a san chuan harsatna lian tak a thlen thei a ni. Chung zingah chuan:

• Lung hnathawh chak lohna thut, rang tak (acute heart failure).
• Lung chhunga tui awm nghal (acute pulmonary edema).
• Kidney function hloh nghal (acute kidney failure).
• Aortic dissection hi i taksaa thisen kalna kawng lian ber, aorta-a mittui tlakna a ni.
• Thluak chhunga thisen chhuak (intracranial hemorrhage).
• Heart attack hi thinlunga thisen kal tlem vang a ni.
• Thluaka thisen kal tlem avanga stroke (`ischemic stroke`).
• Hun engemaw chen thluak hnathawh that lohna (`hypertensive encephalopathy`).

Heng zawng zawng hi eng ang taka pawimawh nge a nih tih hi han ngaihtuah teh. Chuvangin i thisen sang control reng a pawimawh a, ``Hypertensive Crisis'' a lo awm chuan enkawl vat a pawimawh bawk.

Engtin nge doctor-te hian hei hi dik taka an hriat theih?

Doctor chuan i kut pahniha thisen sang a teh hmasa ang. Tichuan, i damdawi lam chanchin an zawt ang a, i natna lan chhuah dan an sawi ang a, taksa enfiahna an nei ang. I natna chhan hriat theihna turin test engemaw zat an tih a ngai thei bawk.

Test chi hrang hrang tih theih a awm a:

• Thisen test a ni
• Zun test a ni
• Electrocardiogram (EKG/ECG) test hmangin thinlung natna chhinchhiahna a awm
• Fundoscopic examination (mit chhung lam enfiah) .
• Neurological exam a ni
• Thinlung ultrasound (Transthoracic echocardiogram) hmanga enfiah a ni.
• A rilru leh lu chu ``Computed Tomography (CT) scan`` hmanga enfiah a ni

Organ thar chhiatna chhinchhiahna i neih chuan i doctor chuan ``Hypertensive Emergency'' i nei tih a hmuchhuak ang che. Chutiang chhinchhiahna a awm loh chuan ``Hypertensive Urgency'' tia hriat a ni ang.

Engtin nge enkawl a nih? A dam thuai thei ang em?

``Hypertensive Crisis'' chu 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.

• Organ chhiatna a awm loh chuan (`Hypertensive Urgency` a awm chuan): Chumi ni vek chuan in lamah i haw thei ang (in lama ei tur damdawi nen).
• Mahse, ``Hypertensive Emergency`` i neih chuan: Damdawi in intensive care unit (ICU)-ah ni engemaw zat i awm a ngai ang. Chutah chuan doctor-te chuan damdawi chu vein-ah direct-in an pe ang che (``IV - intravenous`` method). Tin, i thisen sang pawh an enfiah chhunzawm zel ang.

I medical team chuan i thisen sang tihhniam thuai dan tur chu an rel ang a, i damdawi lam dinhmun dangte chu ngaihtuah chungin. A then phei chuan i thisen sang tihhniam vat chuan i taksa peng leh taksa peng hrang hrangte thisen a dawng tlem thei a ni. Chuvangin, doctor-te chuan i thisen sang zawi zawiin, darkar 24 atanga darkar 48 chhungin an tihhniam thei a ni.

Mahse, aortic dissection, severe preeclampsia, eclampsia ang chi condition i neih chuan doctor-te chuan hypertensive crisis i neih laiin i thisen sang 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.

Damdawi enkawlna atana pek te

``Hypertensive Crisis`` enkawlna atana damdawi pek thin thenkhat chu hetiang hi a ni:

• `Captopril` tih a ni
• `Clevidipine` tih a ni
• `Clonidine` tih a ni
• `Esmolol` tih a ni
• `Hydralazine` tih a ni
• `Labetalol` tih a ni
• `Nicardipine` tih a ni
• `Nifedipine` tih a ni
• `Nitroglycerin` tih a ni
• `Nitroprusside` tih a ni

Doctor ten i mamawh ang damdawi an thlang ang. I damdawi lam dinhmun dang leh i ei tur damdawi dangte pawh an ngaihtuah bawk ang. Chuvangin, heng damdawi te hi i hmuh hian hlauthawng suh, i tana tha ber tur chu doctor/lady hian a rel ang.

Engtikah nge Doctor ka hmuh ang?

I thisen sang 180/120 mm Hg aia sang a nih chuan 911 (1990 Suwaseriya Ambulance Service in Sri Lanka) call nghal la, a nih loh leh damdawi in hnai ber emergency room-ah kal rawh. Enkawlna hmanhmawhthlak i mamawh!

``Hypertensive Crisis'' i enkawl hnuah i doctor pangngai hnenah i hmu ang. I thisen sang damdawi chu ``adjust'' a tum mai thei. Nitin nunah inthlâk danglamna i neih apiang a sawipui bawk ang che.

Entirnan, i ei tur thlak danglam (DASH diet ang diet zawm) emaw, i routine-ah exercise tam zawk dah belh emaw tura fuih i ni thei.

Hetiang hi ka chungah a thleng leh dawn em ni? Eng nge ka hriat tur?

``Hypertensive Crisis'' hi i thisen sang a dik lo tih hriattirna 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 follow-up appointment te vawng reng tur a ni a, i damdawi ei tur chu i doctor-in a tih ang chiah khan ei tur a ni.

Tu pawhin "Crisis" tih thumal an hriat hian hlauhna an nei hi thil pangngai a ni. "Aw, hetiang hian ka thisen sang a sang leh dawn em ni?" ``Hypertensive Crisis'' tih i hriat hian i hriselna leh hmalam hun a nghawng dan tur pawh i ngaihtuah mai thei bawk.

Mahse, i thisen sang hi hetiang taka a san theihna chhan tam tak a awm thei tih hre reng ang che. Doctor-te chu mi tinte tana a chhan danglam bikte hriatchhuah tir an ni. A chhan i hriat hnu chuan a lo thleng leh theihna tur i tihziaawm theih nan hma i la thei ang.

Hei hian i damdawi ei tur hriattirna siam pawh a huam thei. A nih loh leh, chhan dang avanga damdawi i ei chungchang i doctor nena inbiakna leh siamrem tihna a ni thei bawk. Tuna i thisen sang control tura i hmalakna apiang hian nakin lawkah harsatna lian tham tak lakah a venghim ang che.

Hemi atang hian kan hriat reng tur pawimawh ber berte (Take-Home Message) .

Okay, chuti a nih chuan, kan sawi tawh thil pawimawh ber ber, i ngaihtuah reng tur chu kan hriat nawn tir leh ang che?

• Hypertensive crisis chu i thisen sang 180/120 mm Hg aia sang a san chuan a ni. Hei hi medical emergency a ni.
• Hei hi chi hnih a awm a, chungte chu: `Hypertensive Urgency` taksa peng tichhe lo leh `Hypertensive Emergency` taksa peng tichhe lo.
• Symptoms a inang lo. A châng chuan a lan chhuahna a awm lo thei a, a nih loh leh lu na nasa tak, rilru na, leh mit hmuh lohna te pawh a tel thei bawk.
• A chhan ber chu thisen sang damdawi atana an pek tur dik taka ei loh vang a ni. Kidney natna leh damdawi thenkhat pawhin hetiang hi a thlen thei bawk.
• Pressure 180/120 mm Hg aia sang a nih chuan damdawi in pan nghal tur a ni.
• Enkawlnaah hian thisen sang tihhniamna tur damdawi a tel. Damdawi inah i awm a ngai mai thei bawk.
• Hetiang thil a thlen nawn loh nan i doctor thupekte chu uluk takin zawm la, i damdawi ei tur dik tak ei la, a tul anga nunphung thlak danglam rawh.

A tawp berah chuan i thisen sang kha enkawl tha rawh. Check fo thin ang che. A chhan chu, nun hrisel tak nei tur chuan he "silent killer" hi kan hriat chian a pawimawh hle. Zawhna dang i neih chuan i doctor emaw midwife emaw zawh hreh suh. An pui ang che!

` Hypertension, Hypertensive Crisis, Thisen sang, Thisen sang, Lung natna, Pressure, thisen sang