Categories
Biology Covid-19 human body

Post covid-19 syndrome

Long Covid-19
• Fever (83-99%)
• Cough (59-82%)
• Fatigue (44-70%)
• Anorexia (20-84%)
• SOB (31-40%)
• Myalgia (11-35%)
• Others: anosmia, loss of taste, GI, headache
Who gets Long Covid-19?
• Factors that appear to be associated with a greater risk of suffering from
“Long COVID-19” appear to be:
• Increasing age
• Excess weight/ obesity
• DM-2 ,COPD,CKD
• Patients on immunosuppression medication ,organ transplant recipients
• Multiple symptoms at presentation
Fever
• May be treated symptomatically with Paracetamol or non-steroidal antiinflammatory drugs.
• Monitoring functional status in post-acute coivd-19 patients is not yet an
exact science.
Chest Pain
Chest pain is common in post-acute covid-19 syndrome approximate
incidence 12 to 44 %. The clinical priority is to separate musculoskeletal
and other non-specific chest pain from serious cardiovascular conditions.
Cardiopulmonary complications include myocarditis, pericarditis, myocardial
infarction, dysrhythmias, and pulmonary embolus; they may present
several weeks after acute covid-19. They are commoner in patients with
pre-existing cardiovascular disease
Cough
• chronic cough as one that persists beyond eight weeks. Up to that time,
and unless there are signs of super-infection or other complications such
as painful pleural inflammation, cough seems to be best managed with
simple breathing control exercises and medication where indicated.
Thromboembolism
• Covid-19 is an inflammatory and hypercoagulable state, with an increased
risk of thromboembolic events.
• Many hospitalized patients receive prophylactic anticoagulation.
thromboprophylaxis.
• If the patient has been diagnosed with a thrombotic episode,
anticoagulation and further investigation and monitoring should follow
standard guidelines.
Neurological Sequelae
• Ischemic stroke, seizures, encephalitis, and cranial neuropathies have
been described after covid-19, but these all seem to be rare.
• A patient suspected of these serious complications should be referred to a
higher centre.
• Common non-specific neurological symptoms, which seem to co-occur
with fatigue and breathlessness, include headaches, dizziness, and
cognitive blunting (“brain fog”).
Breathlessness
• A degree of breathlessness is common after acute covid-19. Severe
breathlessness, which is rare in patients who were not Hospitalised,may
require urgent referral. Breathlessness tends to improve with breathing
exercises .
• Pulse Oximeters may be extremely useful for assessing and monitoring
respiratory symptoms after covid-19.
• An exertional desaturation test should be performed as part of baseline
assessment for patients whose resting pulse oximeter reading is 96% or
above but whose symptoms suggest exertional desaturation (such as lightheadedness or severe breathlessness on exercise).
• Typically, oxygen saturation (pulse oxymeter) would be a daily reading
taken on a clean, warm finger without nail polish, after resting for 20
minutes; the device should be left to stabilize and the highest reading
obtained should be recorded.
Fatigue
• The profound and prolonged nature of fatigue in some post-acute covid-19patients shares features with chronic fatigue syndrome described after otherserious infections including SARS, MERS, and community acquired pneumonia.
• We found no published research evidence on the efficacy of eitherpharmacological or non-pharmacological interventions on fatigue after covid-19.
• Patient resources on fatigue management and guidance for clinicians on returnto exercise and graded return to performance for athletes in covid-19 arecurrently all based on indirect evidence.
Fatigue Management
which may include:
• Energy management – 3 P’s: plan, priorities and pace,
• Anxiety- Re-assure normal for fatigue after viral infection
• Routine Gentle activity within self assessed limitation Physical activity
advice
• Rest and Sleep
• Hydration and nutrition
• Pain

Categories
Biology human body

Primary Hypertension (Formerly Known as Essential Hypertension)

Essential (primary) hypertension occurs when you have abnormally high blood pressure that’s not the result of a medical condition. This form of high blood pressure is often due to obesity, family history and an unhealthy diet. The condition is reversible with medications and lifestyle changes.


OVERVIEW

What is primary hypertension?

Primary (essential) hypertension is high blood pressure that is multi-factorial and doesn’t have one distinct cause. It’s also known as idiopathic or essential hypertension. Above-normal blood pressure is typically anything over 120/80 mmHg. This means that the pressure inside your arteries is higher than it should be.

Why should I be concerned about essential hypertension?

Essential hypertension (now known as primary hypertension) damages your blood vessels. The condition worsens over time and can cause life-changing complications that include:

SYMPTOMS AND CAUSES

What causes essential primary hypertension?

Unhealthy habits and certain circumstances put you at risk for essential primary hypertension.

These include:

  • Being an older adult (age 65 and up).
  • Diabetes.
  • A diet that’s high in salt.
  • Drinking too much coffee and other forms of caffeine.
  • Family history of high blood pressure.
  • Obesity.
  • Excess consumption of alcoholic beverages.
  • Sedentary lifestyle with limited physical activity.
  • Sleep issues, such as insomnia.

How is primary hypertension different from other forms of hypertension?

Other types of hypertension have one distinct cause. These include a medical condition or side effects of medications. When there is a direct cause, it’s known as secondary hypertension. Primary and secondary hypertension can co-exist, particularly when there’s an acute worsening of blood pressure control, a new secondary cause should be considered.

Conditions that can cause secondary hypertension include:

What are the symptoms of essential hypertension (now known as primary hypertension)?

In the early stages, primary hypertension has no symptoms. Over time, blood vessel damage can start affecting your health.

You may experience:

DIAGNOSIS AND TESTS

How is primary hypertension diagnosed?

A diagnosis of primary hypertension is made when you have high blood pressure, but none of the conditions that cause secondary hypertension. The best way to know if you have it is by seeing a healthcare provider who will:

  • Review your medical history to rule out conditions that cause secondary hypertension.
  • Perform a blood pressure check to determine whether you have high blood pressure.

What happens during a blood pressure check?

Healthcare providers use a device with an inflatable arm cuff and dial. They inflate the cuff and watch the dial while listening to the force of blood through a stethoscope.

The test results in two readings:

  • Systolic pressure (top number) measures pressure when the arteries are full of blood.
  • Diastolic pressure (bottom number) measures pressure when the heart is at rest between beats.

Normal blood pressure is below 120/80 mmHg. If either number is higher, you may have hypertension. Your healthcare provider will take multiple readings at different time points before determining the next steps in your care.

Will I need any other tests?

If there are multiple high blood pressure readings, your healthcare provider may recommend 24-hour ambulatory blood pressure monitoring. This test regularly measures blood pressure over 24 hours, even while you sleep. Healthcare providers take the average of these readings to confirm or rule out a diagnosis of hypertension.

MANAGEMENT AND TREATMENT

What does primary hypertension treatment look like?

Primary hypertension treatment typically includes lifestyle changes and medications.

Lifestyle changes

Maintaining a healthy lifestyle includes:

  • Adding regular exercise to your routine.
  • Avoiding alcohol and recreational drugs.
  • Eating a heart-healthy diet, including low sodium consumption.
  • Maintaining good sleep habits.
  • Quitting smoking if you use tobacco.

Medications

Various medications can lower your blood pressure, including:

  • Angiotensin-converting enzyme (ACE) inhibitors help the body produce less angiotensin, a protein that raises your blood pressure. Captopril tablets are one type of ACE inhibitor.
  • Angiotensin II receptor blockers (ARBs) are medications that prevent blood vessel narrowing.
  • Beta blockers slow your heart rate and reduce the heart’s output, which lowers blood pressure. Metoprolol extended-release capsules are one type of beta blocker.
  • Calcium channel blockers, like diltiazem tablets, decrease the amount of calcium in the blood vessels. This helps muscle tissue relax to relieve narrowing.
  • Diuretics, such as furosemide tablets, help the body eliminate excess water and sodium.
  • Vasodilators help muscles in blood vessel walls relax, making it easier for blood to flow through them.

PREVENTION

How can I prevent essential (primary) hypertension from worsening?

To prevent high blood pressure from worsening you can:

  • Follow all care instructions, such as taking medications in the precise dose at specific times each day.
  • Ask your healthcare provider whether other medications you are taking may affect your blood pressure.
  • Keep all follow-up appointments so your healthcare provider can determine whether treatments are meeting your needs.
  • Stick to lifestyle changes, like quitting smoking and eating healthy.

OUTLOOK / PROGNOSIS

What is the outlook for people with primary hypertension?

Many people lower their blood pressure with medications and lifestyle changes. Some people come off blood pressure medications after maintaining a healthy lifestyle. A small number of people experience no change in blood pressure despite trying several medications (resistant hypertension).

LIVING WITH

What’s important to know about living with primary hypertension?

Medications alone are not enough to lower your blood pressure. For the best results, you need to live a healthy lifestyle.

It can be challenging to change what you eat and break old habits. Some people benefit from the help of health coaches, therapists or trusted friends. Setting realistic goals can help you make steady progress and feel your best.

A note from Cleveland Clinic

Essential hypertension is high blood pressure that is not due to another medical condition. There can be many causes, including obesity, family history and an unhealthy diet. Even though the condition does not cause symptoms, it’s critical to manage it. Essential hypertension can lead to blood vessel damage, putting you at risk for life-threatening complications. With successful treatment, you can lower your blood pressure and preserve your health for years to come.