It is difficult for the physician to tackle low blood pressure. High blood pressure has few symptoms that make it somewhat easy to tackle but the hypotension has no symptoms. If the blood pressure has no symptoms than it is good for the patient but if it results in abnormal body functions than it is difficult to tackle. At times low blood pressure is good at other times it is bad because is unable to pump sufficient blood in different organs of the body.
If the blood pressure of a person is below 120/80 mm hg than it is called low blood pressure. It is witnessed in many people that the systolic blood pressure is less than 100, however in certain people symptoms develop as human organs start to damage due to less blood pumped by the heart.
Causes of low blood pressure
There are three categories in which the clinical symptoms of low blood pressure can emerge. o The heart is not pumping enough pressure;
The artery walls are too dilated; and there is not enough intravascular fluid within the system.
Heart as cause of hypotension
Heart resembles in its function to an electrical pump. In case of low blood pressure either the pump has some problem or the electricity. if the heart beat is very slow then too much time is given to the diastole. Diastole is the time when blood is not flowing. If the heart is beating very quickly than the blood pressure may fall as there is less time for the heart to refill during each beat (diastole).
In case some damage has been occurred to the muscles of heart or some irritation happens in pumping then the heart can not maintain sufficient force to maintain the blood pressure. Myocardial infraction is the heart attack which heart muscles are stunned and can not pump properly.
Valves in blood are programmed to ensure the flow of blood in only one direction. In case valve fails the blood can flow back thus minimizing the quantity of blood that will be sent to the body. Stenotic is the condition in which the valve is shrunk and thus allows less amount of blood to flow. In both cases hypotension develops.
Intravascular fluid as a cause of hypotension
The space within the blood vessels is made up of serum (clotting factors, water, electrolytes and chemicals) and blood cells. Blood flows in this space which is decreased by dehydration, loss of water. Dehydration can be traced in the patients of pneumonia, urinary track and diarrhea where these people are vulnerable to develop hypertension. Burn patients lose the substantial amount of fluid from their burns. Less blood flows through the intravascular space in case of bleeding as the number of red blood cells decrease.
Arterial wall as a cause of hypotension
The muscle tension in the walls of arteries is responsible for changing the intravascular space. In adrenalin the arteries are narrow enough to ncraese the pressure and support blood pressure where acetylcholine dilates the blood vessels and as a result the blood pressure decreases. In normal cases both forces are balanced. Dilation of blood vessels may occur as a result of spinal injury that significantly loss sympathetic tone.
Medication as a cause of hypertension
For controlling the blood pressure often diuretic medicines are used that encourage kidneys to make more and more urine to decrease the intravascular space. In case of excessive urine the patient is dehydrated and thus expected to develop hypotension.
For the treatment of hypertension calcium channel blockers and beta blockers are commonly used as they can make heart to beat slowly. Risk is associated in taking such medicines as the too slow heart beat is hypotension. If it is necessary to under go such medication than the treatment must be strictly observed by a physician.
Pregnancy also leads to hypotension.
Endocrine as a cause of low blood pressure
The body functions are usually adjusted and managed by the help of hormones. The pituitary gland in the brain is associated with the glands in the body and responsible for regulating the body.
Hypothyroidism, less function of thyroid gland is often related to the hypotension. The cortisone hormone level in the body is decreased by abnormalities in adrenal gland. In certain situations, low blood pressure is observed. Abnormal or low function of pituitary is also a cause of low blood pressure. The sugar patients may also suffer from hypotension as a result of reduced amount of sugar. Hyperglycemia is the state in which the blood sugar is too high which can result in low blood pressure and dehydration.
Symptoms of low blood pressure
There will be no symptoms in a person whose blood pressure is normally stays low. In symptomatic blood pressure the person may feel dizziness, short of breath, lightheaded, chest pain and weakness. The symptoms will always depend upon the organ that is deprived of sufficient amount of blood due to less pumping capacity of the heart.
Examining and testing low blood pressure
Physical examination and good history is key to the diagnosis of hypotension. In case no other symptoms but low blood pressure is suddenly discovered than the physician must jot down the reading to remember that it has occurred once, and when.
In case symptoms have started to appear than the health care visitor has to document risk factors and the potential causes of the situation in the light of detailed history. Things to keep in mind are the occurring of symptoms, complains associated with the low blood pressure and a proper review of the illness and medications of past.
Postural vital signs are mostly included in the physical examination. The blood pressure and the pulse rate of the patient is taken while he is standing, laying flat and sitting. Decrease in intravascular space due to bleeding or dehydration is forecasted if the pulse rate increase or the blood pressure decreases during these readings. Other examinations will be suggested by keeping in mind the history. Palpitation of the thyroid gland in neck, examination of the extremities and abdomen and listening to the heart may be included in further evaluation.
Physical examination and substantial history may also suggest blood test to make the scene clear. If shortness of breath or chest pain is associated with low blood pressure than electrocardiogram (ECG or EKG) may also be suggested.
Treatment of low blood pressure
The low blood pressure with no symptoms is avoided to deal with as treatment is not required. As soon as the diagnosis of low blood pressure is made and shortness of breath, chest pain and active bleeding is discovered to be associated treatment is started. For further care the health care provider must shift the patient to emergency ward as the symptoms are life threatening. The patient can also be in shock. Shock is a state in which the organs are unable to function properly due to lack of blood supply.
Oxygen and intravenous fluids may be given to the patient while his or her heart is constantly monitored. Certain therapies can also be initiated without even firm diagnosis based upon the potential diagnosis and underlying complaints. For example a patient of infection is provided with antibiotics, an antihistamine and adrenaline is given to the patient who has allergic reactions or a patient with bleeding is provided with blood transfusion.
In case of a person who has a history of symptoms and is feeling normal by the virtue of care the health care provider finds ample time and surroundings to make his evaluation more specific. As a result he can match the cause of the low blood pressure with the treatment and suggest more substantial treatment.
Hospital sittings are suggested for those people who have abnormally low readings of their blood pressure. The examination will again based on patient presentation and the specific situation.
Blood pressure whether low or high is a disease that is commonly observed in every other person especially in under developed nations. High blood pressure has its treatment in exercise and weight loss where the low blood pressure is dangerous as far as treatment is concerned. However, abnormal blood pressure is dangerous and the best treatment is precaution. Proper diet, regular exercise and thorough examination are the keys to long and healthy life.