What is the disease with palpitations, chest tightness and shortness of breath?

In daily life, when it comes to blood pressure diseases, the first thing people think of is hypertension, and most patients with hypertension are elderly people. Perhaps it is due to the aging of the body, or perhaps it is due to other reasons, but in short, hypertension is a relatively serious disease. So the question is, people always feel their heartbeats speed up and their chests feel short of breath. What disease causes these symptoms?

Hypotension is a condition in which systemic arterial pressure is lower than normal. Since hypertension often causes damage to important organs such as the heart, brain, and kidneys in clinical practice, it has received much attention. The World Health Organization also has clear provisions for the diagnostic criteria for hypertension, but there is no unified standard for the diagnosis of hypotension. It is generally believed that an adult's upper limb arterial blood pressure lower than 12/8kPa (90/60mmHg) is considered hypotension. According to the cause, it can be divided into physiological and pathological hypotension, and according to the onset form, it can be divided into acute and chronic hypotension.

Causes

1. Physiological hypotension

It refers to a group of healthy people whose blood pressure measurements have reached the standard for low blood pressure, but who have no subjective symptoms. After long-term follow-up, except for low blood pressure, there are no abnormalities such as ischemia and hypoxia in various systems and organs of the human body, and their life span is not affected.

2. Pathological hypotension

In addition to lowered blood pressure, it is often accompanied by symptoms of varying degrees and certain diseases.

(1) Primary hypotension refers to a state of low blood pressure without obvious cause, such as physiological hypotension (constitutional hypotension), which is more common in frail elderly people and women.

(2) Secondary hypotension

Refers to the lowering of blood pressure caused by a disease of a certain organ or system in the human body. This type of hypotension can occur rapidly in a short period of time, such as a sharp drop in blood pressure caused by massive bleeding, acute myocardial infarction, severe trauma, infection, allergies, etc. In most cases, hypotension occurs slowly and may gradually worsen, such as hypotension secondary to severe pulmonary tuberculosis, malignant tumors, malnutrition, cachexia, etc.

Clinical manifestations

According to the onset of hypotension, it can be divided into two categories: acute and chronic.

1. Acute hypotension

Acute hypotension refers to a sudden and significant drop in the patient's blood pressure from a normal or high level. Clinically, it is often caused by ischemia of important organs such as the brain, heart, and kidneys, and symptoms such as dizziness, black eyes, weak limbs, cold sweats, palpitations, and oliguria. Severe cases may manifest as syncope or shock.

2. Chronic hypotension

Chronic hypotension refers to a state in which blood pressure is persistently below the normal range.

(1) Constitutional hypotension

It is generally believed to be related to genetics and weak physique, and is more common in women and the elderly aged 20 to 50. Mild cases may have no symptoms, while severe cases may experience mental fatigue, dizziness, headache, and even fainting. It is more obvious in summer when the temperature is higher.

(2) Postural hypotension

In some patients, hypotension is related to changes in body position (especially upright position), which is called orthostatic hypotension. Postural hypotension is defined as a decrease in systolic blood pressure >20 mmHg or diastolic blood pressure >10 mmHg within 3 minutes of changing body position to an upright position, accompanied by symptoms of hypoperfusion, including dizziness, lightheadedness, blurred vision, fatigue, nausea, cognitive impairment, palpitations, and neck and back pain. Elderly people with isolated systolic hypertension accompanied by diabetes, hypovolemia, or the use of diuretics, vasodilators, or psychotropic drugs are prone to orthostatic hypotension.

(3) Secondary hypotension

Certain diseases or drugs can cause hypotension, such as syringomyelia, severe aortic valve stenosis, mitral valve stenosis, chronic constrictive pericarditis, idiopathic or hypertrophic cardiomyopathy, hemodialysis patients and chronic malnutrition, as well as taking antihypertensive drugs and antidepressants. Hypotension caused by these diseases can also cause symptoms of low perfusion such as dizziness and lightheadedness.