3 minute read
Clinical manifestations of
PATIENTS WITH HYPERTENSIVE CRISES
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Author: Mykhaylo Podluzhny Scientific Coordinator: Sid’ E. V., PhD, associate professor Institution: Chair of emergency medical service, State Institute «Zaporizhzhia Medical Academy of Postgraduate Education of Ministry of Health of Ukraine»
INTRODUCTION: The occurrence of arrhythmias among patients with hypertension (HT) has become the basis of numerous studies. It remains interesting to determine the clinical manifestations of the first detected atrial fibrillation (FD AF) on the background of HT in the development of hypertensive crises (HC).
AIM: To determine the clinical manifestations of the first detected atrial fibrillation in a group of patients with hypertension during the development of hypertensive crises.
MATERIAL AND METHODS: The research results are based on a survey of 73 patients with documented HT in the state of HC during the emergency medical help on the prehospital phase. All studied were subjected to anamnestic, general clinical and instrumental examination to verify the diagnosis, identify complications and associated pathology.
RESULTS: The number of patients in the first group with HT combined with FDAF during the development of HC was 38 people (22 men and 16 women), with an average age of age 57.4 ± 1.0. The quantity of the second group of patients with HT during the development of HC without AF was 35 people (17 men and 18 women), with an average age of 57.2 ± 0.9. The groups were comparable in age and duration of HT. Analysis of complaints in patients with HC showed that the prevalence of the main symptoms in the first group were: shortness of breath - 23(60.5%), headache - 1(2.6%), dizziness - 6(15.8%), heart interruptions - 14 (36.8%), palpitation - 26 (68.4%). In the second group: shortness of breath - 5(14.3%), headache - 33(94.3%), dizziness - 23(65.7%), heart interruptions - 8(22.9%), palpitation - 15(42.9%). Only heart interruptions did not have a significant difference between the groups by the criterion 2(p>0.05). Clinical manifestations such as shortness of breath and palpitations were more prevalent among patients with HT combined with the FDAF and development of HC(p<0.05), but headache and dizziness were prevalent among patients with HT during the development of HC without AF (p<0.05). The results of ROC-analysis showed that heart interruptions, as a manifestation of the FDAF among patients with HT during the development of HC (AUC = 0,576, 95% CI AUC 0,457 to 0,689) had a sensitivity of 36.84% and specificity of 78.38%. Also, palpitations, as a manifestation of FDAF among patients with HT during the development of HC, had a sensitivity of 68.42% and specificity of 59.46% at AUC = 0.639, 95% CI AUC 0.520 to 0.747.
CONCLUSION: Palpitation was the most frequent clinical manifestation accompanying the FDAF among 26 (68.4%) patients with HT during the development of HC. Heart interruptions and palpitations among patients with HT during the development of HC had insufficient sensitivity and specificity for AF. Patients with developing HC require mandatory ECG registration before emergency medical treatment to determine further treatment tactics.
Questions & answers
Please, tell us a little bit more about yourself. My name is Mykhaylo Podluzhny. I am from Zaporizhzhya, Ukraine. It is an old historical and industrial big city in the East of Ukraine. I am interested in cardiac cellular electrophysiology. Right now I am studying in Zaporizhzhya State Medical University and working in the CVICU of Zaporizhzhya Regional Center of Cardiovascular diseases. Furthermore I am keen on sports, especially, on grappling.
Tell us a bit more about your research and its significance. My research was performed when I was working on the ambulance so all of the patients contacted me directly. The significance is that now a lot of people think that if they have any diseases, especially arrhythmias, they will have significant sign of it, but my research shows that it is incorrect.
What was the biggest challenge while carrying out the research and how did you overcome that? There were some problems with contacting patients but during research I became more experienced and self-confident so patients started believing me.
In your opinion, what is the benefit of joining ESSP and what advice do you have for students undertaking research in the future? This helps me to spread my idea and to help healthcare professionals deeper understand this topic. I highly recommend to join this initiative and to make your voice be heard.
