Arterial hypotension

from Wikipedia, the free encyclopedia
Classification according to ICD-10
I95.0 Idiopathic hypotension
I95.1 Orthostatic hypotension
I95.2 Drug hypotension
I95.8 Other hypotension
I95.9 Hypotension, unspecified
O26.5 Maternal hypotension syndrome
ICD-10 online (WHO version 2019)
Blood pressure monitor

The arterial hypotension (from ancient Greek ἀρτηρία artería "artery", "pulse artery", ὑπό hypó "under" and τόνος tónos "tension"), also hypotension or hypotension , is a blood pressure that is too low for the maintenance of normal body functions and according to the ICD-10 -Classification a disease of the circulatory system.

In relation to the vascular system of animals and humans, hypotension describes a blood pressure that is permanently below a defined normal limit at rest. In Germany, arterial hypotension usually refers to a systolic blood pressure less than 100 (in men also less than 110) mmHg , the National Heart, Lung, and Blood Institute (NHLBI in USA) specifies 90/60 mmHg as a limit value. One speaks of low blood pressure in contrast to high blood pressure .

Pathophysiology

The cause of arterial hypotension is a disproportion between vessel volume and circulating blood volume. This disproportion can result from reduced vascular resistance, insufficient absolute blood volume, insufficient blood return flow to the heart or reduced pumping function of the heart:

Pathophysiology Cause (examples)
decreased vascular resistance Anaphylactic or spinal shock
reduced absolute blood volume low fluid intake, blood loss, diarrhea or vomiting, adrenal insufficiency
decreased blood return to the heart Varicose veins , taking medication, e.g. B. nitroglycerin , vena cava compression syndrome , pulmonary embolism
reduced pumping function of the heart Heart failure , (severe) aortic stenosis , pericardial effusion

Forms of hypotension

Depending on the cause, there are three types of arterial hypotension.

Idiopathic hypotension

The most common form of hypotension is idiopathic hypotension (I95.0), i. H. its cause is unclear. It is more common in young, slim women.

Symptomatic hypotension

As symptomatic hypotension refers to low blood pressure, for a clearly defined cause. B. a disease or medication.

A drop in blood pressure that occurs after eating, particularly in older people, is called postprandial hypotension.

Orthostatic hypotension

Orthostatic hypotension: standing becomes a problem

The orthostatic hypotension (I95.1), (Greek of (.) = Orthostatic upright stand) is also known as orthostatic hypotension or -orthostatic syndrome called.

When orthostatic hypotension malfunction lies orthostatic reaction before. In healthy people, this orthostasis reaction ensures that the cardiovascular system works properly even in an upright position. Due to the malfunction in orthostatic hypotension, signs such as dizziness, palpitations, nausea and weakness occur in an upright position, which force you to sit down or lie down, and the symptoms quickly subside. In some patients, circulatory syncope (short-term unconsciousness) occur.

The resting blood pressure when lying or sitting can be decreased, normal or increased regardless of the orthostatic dysregulation .

Symptoms

  • Pallor, cold hands and feet
  • Tremble
  • easy fatigue, poor concentration
  • dizziness
  • a headache
  • Tachycardia
  • Tendency to collapse, syncope

The occurrence of brief fainting fits (syncope) is of the greatest relevance. The low blood pressure - compared to the ideal value (120/80 mmHg) - leads to an insufficient supply of the brain with oxygen-rich blood and thus to unconsciousness. This often leads to falls and related injuries.

Arterial hypotension is common in teenagers who are slim or underweight.

Diagnosis

Long-term hypotension should be clarified by a doctor. The most important goal of diagnostics is to identify or exclude symptomatic hypotension, as it can be an expression of a potentially life-threatening disease. In addition to anamnesis and clinical examination, apparatus-based procedures such as echocardiography or long-term blood pressure measurement and a blood test are important. In the diagnosis of orthostatic hypotension, the Schellong test and tilt table examination play a decisive role.

therapy

In the long term, arterial hypotension is more favorable than hypertension in terms of the cardiovascular risk. If there is no identifiable illness, therapy is therefore only indicated in the event of symptoms and is carried out through physical measures such as sport, gymnastics and alternating showers and a change in diet (high-salt meals with increased fluid intake). Drug therapy with sympathomimetics , dihydroergotamine or mineralocorticoids is only rarely indicated. These drugs are called antihypotonic drugs . They raise blood pressure.

Controlled hypotension

Controlled hypotension is a method of deliberately lowering a patient's blood pressure during surgery to reduce blood loss. It is particularly effective in orthopedic surgery, but it can also be used in other types of surgery.

See also

Web links

Wiktionary: Hypotension  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ^ Willibald Pschyrembel : Clinical Dictionary , 266th edition, Walter de Gruyter, Berlin, Boston , 2014, p. 980, ISBN 978-3-11-033997-0 .
  2. ↑ Renate Wahrig-Burfeind (Ed.): True. Illustrated dictionary of the German language . ADAC-Verlag, Munich 2004, ISBN 3-577-10051-6 , pp. 67, 405 .
  3. ↑ a b ICD-10-GM (2016), Diseases of the Circulatory System ( Memento of the original from July 2, 2016 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved August 21, 2016. @1@ 2Template: Webachiv / IABot / www.dimdi.de
  4. ↑ a b c d Gerd Herold : Internal medicine . Cologne 2017, p. 315-316 .
  5. ↑ National Heart, Lung, and Blood Institute. What is hypotension? Retrieved January 15, 2011.
  6. ↑ a b hypotension. In: Alexander and Konstantin Bob (eds.): Internal medicine. Pp. 744-745. Thieme Verlag, Stuttgart 2001. ISBN 3-13-128751-9 .
  7. ↑ a b Medicine Knowledge Online, Orthostatic Hypotension . Retrieved August 19, 2016.
  8. ↑ Rolf R. Diehl: Postural Tachycardia Syndrome , in: Deutsches Ärzteblatt, vol. 100, issue 43, October 2003. Accessed August 19, 2016.
  9. ↑ http://www.bluthochdruck.de/
  10. ^ W. von Scheidt and P. Trenkwalder: Chronic Arterial Hypotonia. In: Gerhard Steinbeck and Gustav Paumgartner (Eds.): Therapy of Inner Diseases. 11th edition (2005), Springer Verlag , ISBN 978-3-540-26504-7 . P. 232 ff.
  11. ↑ Eberhard Hackenthal: Treatment of hypotension and shock. In: Eckard Oberdisse, Eberhard Hackenthal and Klaus Kuschinsky (eds.): Pharmakologie und Toxikologie , 3rd edition (2002), Springer Verlag , ISBN 3-540-41993-4 and ISBN 978-3-540-41993-8 , p 395.
  12. ^ " Red List 2016", 56th edition, Frankfurt am Main , ISBN 978-3-946057-00-0 and ISBN 978-3-946057-01-7 , page 158 and chapter 19.
  13. ↑ Consilium Cedip Practicum 2006 , Manual for Diagnosis and Therapy, 28th edition, JMS Verlag, Cologne, ISBN 3-9810440-1-0 , page 744.
  14. ↑ Hubert Mörl: Vascular Diseases in Practice , Edition Medicine, Weinheim, Deerfield Beach, Florida , and Basel 1983, ISBN 3-527-15079-X , page 157.