Hyperemia- Types, Causes, and Treatment

Introduction

Hyperemia is a process where the blood supply to organs increases. There are different reasons for hyperemia to occur. Hyperemia can be just a body's physical response, or it might indicate a diseased condition.

What Are the Types of Hyperemia?

There are two types of hyperemia:

• Active Hyperemia - When the blood flow to an organ increases, it causes active hyperemia. It generally happens when the blood supply to an organ is usually a normal physiological response of the body. The blood flow to the body’s tissue increases with increased oxygen and nutrient demand. As a result, the blood vessels become wide to increase the blood supply. There are two types of active hyperemia:

  • Acute General Active Hyperemia - Increased blood supply in the entire body results in acute general active hyperemia.

  • Acute Local Active Hyperemia - Increased blood supply in a particular body area, such as legs, lungs, etc., results in acute local active hyperemia. It is the most commonly seen hyperemia in the body.

• Passive Hyperemia - When the blood cannot be pumped out of an organ completely, it starts pooling inside the blood vessels and the organ itself, known as passive hyperemia. The most common cause is impaired function of blood vessels or a blockage present in the blood vessel. The most common organs affected are the lungs, liver, and lower limbs. Passive hyperemia is also known as congestion. Usually, passive hyperemia affects one area of the body. However, in case of impaired blood flow in the heart, the entire body system is affected.

What Are the Causes of Hyperemia?

The causes of hyperemia depend on the type of hyperemia:

Active Hyperemia

• Exercise - The body remains active while exercising; hence, the heart and the muscles need more oxygen. Blood flows in abundance to make up for extra oxygen.

• Heat - In case of high fever or when the weather is hot, more blood flows to the skin and releases heat.

• Digestion - Upon eating, more blood is required by the stomach and intestines to break the food and absorb the nutrition.

• Inflammation - In case of an injury or infection, the blood supply in that area increases to fight against infection and repair the tissue. The blood supply provides the mediators of immunity and fights against trauma and infection. Infection and trauma result in swelling and hyperemia.

• Menopause - Women experience hot flashes during menopause. As a result, the blood supply increases to the skin. The most common areas are the face, neck, and chest. A similar phenomenon is seen during blushing.

• Blockage - when an artery or vein is blocked or restricted, blood flow increases in the area. Once the blockage is removed, blood flow becomes normal in the area. A few examples of hyperemia are ischemia of an organ and bed rest.

Passive Hyperemia

• Heart Failure - The right and left ventricles of the heart pump blood to different parts of the body. The right ventricle pumps blood from the heart to the lungs, and the left ventricle pumps blood to different body parts. If the heart is not functioning properly, it cannot pump blood efficiently to different body parts resulting in blood pooling within the heart. This pooling results in swelling and congestion of the organs like the liver, lungs, spleen, and kidneys and results in serious health issues.

• Blockage of the Blood Vessels - Blockage of an artery or vein can result in increased blood supply and hence hyperemia. One example is bed sores, where constant pressure on the veins due to bed rest leads to hyperemia and bed sores.

• Thrombosis - Thrombosis is the formation of a blood clot in the artery or veins. When thrombus formation occurs, it causes the accumulation of blood. Any part of the body can be affected by thrombosis; however, the most common forms of thrombosis are deep vein thrombosis affecting the lower limbs, and hepatic vein thrombosis, affecting the liver. Other conditions that can lead to thrombosis are:

1. Obesity.

2. Diabetes.

3. Birth control medications.

4. Fractures.

5. Smoking.

6. Diabetes and high blood pressure.

What Are the Signs and Symptoms of Hyperemia?

The main symptoms of hyperemia are redness and warmth of the skin. Other symptoms, depending on the cause of hyperemia, include shortness of breath, chest pain, swelling, fast heartbeat, etc. Deep vein thrombosis causes pain, swelling of the feet, and redness of the legs. Hepatic vein thrombosis causes pain in the right side of the stomach, itching, and swelling.

What Is the Treatment of Hyperemia?

Treatment of hyperemia depends on its cause as it is a sign of an underlying diseased condition.

• Active Hyperemia

  • Active hyperemia due to exercise, digestion, or heat does not require any treatment. However, the enhanced blood supply will decrease once the activity stops.

  • Active hyperemia due to fever, infection, and inflammation is treated with medicines to subside the symptoms. However, in case the symptoms worsen, medical attention is needed.

• Passive Hyperemia - It is treated after the diagnosis of the diseased condition.

  • Heart failure is treated after diagnosing the cause of heart failure, like high blood pressure and diabetes.

  • Lifestyle modification and a healthy diet are included.

  • Regular exercise and weight reduction.

  • Deep vein thrombosis and hepatic vein thrombosis are treated with blood thinners like heparin and warfarin.

  • Patients diagnosed with high blood pressure and diabetes are given medicines to regulate it within the normal range.

What Are the Effects and Complications of Hyperemia?

The type of hyperemia decides the complications that will occur. For example, acute hyperemia in case of injuries and fever denotes inflammation. On the other hand, passive hyperemia is majorly linked to organ congestion and can result from heart disease, liver disease, or lung disease.

Conclusion:

The prognosis of hyperemia depends on its cause which is either health or disease. The microcirculatory system comprises arterioles, capillaries, and venules and plays a vital role in the mechanism of hyperemia. Microcirculation is managed by the sympathetic vasoconstrictor signals sent by the brain and vasoactive substances (impacts the blood pressure and heart rate) produced by the endothelial cells. One of the most important vasoactive substances is nitric oxide. It relaxes the smooth muscles of the blood vessels and increases blood flow. During illness, the nervous and endothelial control of the blood supply is affected. Ischemic changes can be seen in the organs where the neurological and vascular disease affects the microcirculation. Sepsis or trauma results in irreversible microcirculation damage, resulting in organ failure and death.