Hypertonia

[Lena21]

Hello, the Doctor!
To my husband of 47 years. Chronic diseases - a gout and a pancreatitis. One week ago has felt a malaise - a giddiness, strong reddening and a burning sensation of the face, a strong pain in ribs (from the left party or side). The pain is felt at pressing, sharp turn. Pressure 110/140. The doctor has registered the tablets lowering pressure and broth of Leonurus. However, later almost week appreciable improvement does not come. And sensation, as he said, such: "... If to me to cast it is a little blood, to me it becomes easier... ". Help or assist what to do or make, please?

[VOLKON]

Hello!

You have not written, whether pressure upon a background of reception of tablets has decreased. If is not present, treatment means is necessary to change - either to increase a dose, or to replace a preparation. Now so it is a lot of effective medicines, that problems practically do not happen to pressure decrease. Besides age of your husband already such when it is possible to expect any vascular accidents. That them to avoid, it is necessary to check up a level of a cholesterin in a blood (by the way, at a gout he is quite often raised or increased) and if he will appear really high - to reduce by means of a diet and tablets. It is necessary to check up heart - to make not only a simple electrocardiogram. But also daily monitoring and veloergometriju. And certainly to eliminate or erase;remove all so-called risk-factors - smoking, excess weight, an inactive way of life, etc.

[Lena21]

Good afternoon, Vladimir Olegovich.
Thanks for the answer.
Whether pressure has decreased is known, since there is no apparatus. And tablets which were registered by the doctor (ENAP - .20. 3 times a day) he drinks reception of 1/2 tablets 5 days, and improvements and there is no, and, the most important, this pain in the field of heart and does not pass or take place. Yes, I have incorrectly specified pressure--100/160. I, think, hardly pressure has decreased, signs have remained. Can be replace a medicine?

[VOLKON]

Hello!

Do not hurry to change a medicine. Enap it is strong enough preparation, and 30 mg - a good dose. But he develops or unwraps the action not at once. Should pass or take place 2-3 weeks. It is necessary to check a level of pressure. The apparatus buy or purchase urgently. And on subjective sensations to be guided difficultly enough.

[Yemelyanov]

By complaints: pains and a hypertonia in this case are not connected among themselves. Takes place ostehondroz (exacerbation) of a cervicothoracic department which gives a pain. In this case I would recommend reception of analgetics (Baralginum, analgin, diclofenac, it it is possible in injections). Enap I personally not so like and I prefer to appoint or nominate others IAPF, but at pressure 160/100 under references the CART monoterpija is not always effective and it is better to use combinations of small doses of preparations, I would add in the evening fiziotenz 0,2 mg, and have lowered dose IAPF though such advice or councils on the Internet to give difficultly.
Success.

[TYU]

WHETHER PLEASE RESPOND THERE ARE STANDARDS ON TREATMENT OF HYPERTONIC CRISISES IN THE WEST AND WHERE THEY CAN BE FOUND THANK SERGEJ

[VOLKON]

Yes, certain standards or algorithms of treatment of a hypertonic crisis exist. They can be found in different places, for example, in the Management or Manual by internal illnesses or diseases (the Merck Manual), publishing house " World ", Moscow, 1997. However, in my opinion, all so-called standards are done or made only that the inept doctor could be justified in court. Yes, all has been made correctly, but the patient, unfortunately, has died. Iatrotechnics (instead of services) in that also consists, that in each concrete case the doctor chooses the optimal tactics, I am guided thus by experience, knowledge, and at times and intuition.