HYPERTENSION IN EMBRYOMA (WILMS' TUMOR)

PEDIATRICS ◽  
1949 ◽  
Vol 3 (2) ◽  
pp. 201-207
Author(s):  
JAMES G. HUGHES ◽  
HERMAN ROSENBLUM ◽  
LACY G. HORN
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Clinical Features ◽  
Wilms Tumor ◽  
Hypertensive Encephalopathy ◽  
Renal Ischemia ◽  
Cerebral Anoxia ◽  
Cardiac Decompensation ◽  
First Case ◽  
The Right

A case of Wilms' tumor of the right kidney is presented, in which the dominant clinical features were extreme elevation of blood pressure and hypertensive encephalopathy, associated with cardiac decompensation and death. Generalized convulsions and right hemiplegia developed, believed to have been due to cerebral anoxia incident to angiospasm. No metastases were found, and no other cause for arterial hypertension was discovered. This patient is thought to be the first case reported where death from Wilms' tumor was due to the hypertensive factor. The literature with reference to the association of hypertension with Wilms' tumor is reviewed. The mechanisms by which Wilms' tumors may produce unilateral renal ischemia with arterial hypertension are discussed. The presence of clearcut hypertension in a child with a kidney area mass points toward the probability of a Wilms' tumor.

PHAEOCHROMOCYTOMA OF URINARY BLADDER

1962 ◽  
Vol 39 (1) ◽  
pp. 1-12 ◽  
Author(s):  
R. Mićić ◽  
M. Kičić ◽  
S. Adanja
Keyword(s):  
Blood Pressure ◽  
Urinary Bladder ◽  
Arterial Hypertension ◽  
Bladder Wall ◽  
Short Review ◽  
Uneventful Recovery ◽  
Urinary Bladder Wall ◽  
The Right ◽  
Catecholamines In Urine

ABSTRACT A case of phaeochromocytoma localized in the urinary bladder wall above the right ureter in a 19 years old male is described. The patient had a sustained arterial hypertension between 170/120 and 260/170, without haematuria, with regular headache and palpitations immediately after urination. Catecholamines in urine 409 and 340 micrograms per day. A partial resection of the urinary bladder wall was performed with extirpation of a tumour weighing 40 g. Size of the tumour 80 × 60 × 60 mm. The tumour contained 1.5 mg adrenaline and 0.03 mg noradrenaline per g of tissue. Postoperatively blood pressure 140/90, catecholamines in the urine normal, and the patient made an uneventful recovery. The last follow-up ten months after operation. A short review of previously published cases is given.

scholarly journals INFLUENCE OF NOCTURNAL INCREASE OF BLOOD PRESSURE ON CARDIAC REMODELING IN PATIENTS WITH ARTERIAL HYPERTENSION

2019 ◽  
Vol 19 (1-2) ◽  
pp. 65-69
Author(s):  
A. I Miroshnichenko ◽  
K. M Ivanov
Keyword(s):  
Blood Pressure ◽  
Left Ventricle ◽  
Right Ventricle ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Cardiac Remodeling ◽  
Interventricular Septum ◽  
Posterior Wall ◽  
The Right ◽  
Group 1

Actuality. Arterial hypertension (AH) is the main risk factor for the development of cardiovascular diseases, disability and cardiovascular mortality. Episodes of blood pressure (BP) increase during the day in patients receiving antihypertensive therapy are an unfavourable factor contributing to the development and progression of cardiac remodeling. Aim. The purpose of the research is to study the features of changes in the structural and functional state of the heart under the influence of high blood pressure at night in patients with arterial hypertension with the dynamic three-year observation. Material and methods. 47 patients with the diagnosis of AH were examined. Patients were divided into two groups, randomized by age, duration and severity of AH. Group 1 included 24 patients who as a result of ambulatory blood pressure monitoring (ABPM) on the background of combined antihypertensive therapy suffered from constantly increased BP at night. The second group combined 23 patients without the increase in BP during the night according to the ABPM with antihypertensive therapy. The examination included measurement of the office BP, ABPM, two-fold echocardiography with a three-year interval. Results. When assessing the indices of office BP in the groups, there were no significant differences, all patients achieved the target values of BP. In patients in Group 1, higher values of BP were observed during the day, according to ABPM. Echocardiography over a three year period of observation revealed a more pronounced increase in diastolic interventricular septum thickness, the thickness of the left ventricle posterior wall during diastole, sizes of left atrium in the patients of the first group, patients of the second group had a more pronounced thickness of the left ventricle posterior wall during systole. The increase in the size of the right ventricle was revealed in both groups. Conclusions. 1) In patients with the increase in blood pressure at night, the values of BP variability were higher during the day. 2) Three-year dynamic observation revealed that the increase in BP at night in patients with hypertension facilitated acceleration of cardiac remodelling and was associated with an increase in the left ventricular posterior wall, interventricular septum thickness, the size of the left atrium, and the size of the right ventricle.

scholarly journals The Distance Monitoring of Blood Pressure as a Tool for Improving of the Quality of Follow-Up Observation of Patients with Arterial Hypertension

2021 ◽  
Vol 11 (4) ◽  
pp. 255-263
Author(s):  
I. A. Starodubtseva ◽  
Yu. A. Sharapova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Cardiovascular Complications ◽  
Pressure Monitoring ◽  
Blood Pressure Targets ◽  
Distance Counseling ◽  
The Right

This article focuses on the distant blood pressure monitoring for patients with arterial hypertension. As numerous studies show, even slightly elevated blood pressure significantly raises the risk of cardiovascular complications. And, vice versa, a 5 mmHg decrease in blood pressure reduces the lethality risk. Therefore, it is not enough to prescribe the right medication but also it is of paramount importance to monitor patients’ compliance with the treatment. Clinical observation of patients with arterial hypertension is an effective tool for the prevention of cardiovascular complications. However, to date, the coverage of follow-up and the achievement of blood pressure targets in patients with arterial hypertension is one of the most problematic aspects. Distance monitoring of blood pressure opens more opportunities for the doctor’s involvement, timely assessment and adjustment of the medication. The results of domestic and foreign research show high efficacy of the distance blood pressure monitoring. Positive results regarding the achievement of target blood pressure after 3 months are shown when using the technology of blood pressure monitoring and distance counseling of patients with arterial hypertension. In particular, the article considers the technology of mobile health care (mHealth), which is a more flexible platform for a patient’s continuous self-care.

scholarly journals Treatment for complicated hypertensive crisis prior to hospital admission

2004 ◽  
Vol 10 (2) ◽  
pp. 122-126
Author(s):  
O. B. Polosyants ◽  
A. L. Vertkin
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Clinical Symptoms ◽  
Hypertensive Crisis ◽  
Hypertensive Encephalopathy ◽  
Left Ventricular ◽  
Cardiac Complications ◽  
Ventricular Failure ◽  
Baseline Values ◽  
Ischemic Attack

The effects of parenteral enaprilat were evaluated in hypertensive crisis (HC) with cerebral (hypertensive encephalopathy, stroke, transient ischemic attack) or cardiac (acute left ventricular failure, unstable angina) complications. The study covered 190 patients whose mean age was 64.8 years; there were 46 males and 144 females. Cerebral complications due to HC were observed in 119 patients; its cardiac complications were in 71. The decrease in blood pressure (BP) by 15-30 % of the baseline values with achieved diastolic BP less than 110 mm Hg was a criterion for the efficiency of therapy. Changes in clinical symptoms and outcomes were also taken into account. The treatment caused a significant decrease In BP and effective in 64, 80, 74, 72, and 82 % of the patients, respectively. Thus, the study demonstrated that intravenous enaprilat was highly effective in complicated arterial hypertension.

scholarly journals Dyspnea, Tachycardia, and New Onset Seizure as a Presentation of Wilms Tumor: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Linda Li ◽  
Jennifer Light ◽  
Michael Marchick ◽  
Robyn Hoelle
Keyword(s):  
Pulmonary Embolism ◽  
Abdominal Pain ◽  
Wilms Tumor ◽  
Abdominal Mass ◽  
Onset Seizure ◽  
Care Givers ◽  
First Case ◽  
The Right ◽  
Vague Abdominal Pain ◽  
New Onset

Wilms tumor is found in 1 in 10,000 children and most commonly presents in asymptomatic toddlers whose care givers notice a nontender abdominal mass in the right upper quadrant. This case of Wilms tumor presented as a critically ill eleven-year old with significant tachypnea, dyspnea, vague abdominal pain, intermittent emesis, new onset seizure, metabolic acidosis, and hypoxemia. This is the first case in the literature of Wilms Tumor with cavoatrial involvement and seizure and pulmonary embolism resulting in aggressive resuscitation and treatment. Treatment included anticoagulation, chemotherapy, nephrectomy, and surgical resection of thrombi, followed by adjunctive chemotherapy with pulmonary radiation.

scholarly journals Resistant arterial hypertension in patient with pheochromocytoma/paraganglioma

2020 ◽  
Vol 26 (6) ◽  
pp. 77-85
Author(s):  
L. A. Mishchenko ◽  
L. V. Bezrodna ◽  
O. O. Matova ◽  
O. A. Tovkay ◽  
P. O. Lishchynskyi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Adrenal Gland ◽  
Arterial Hypertension ◽  
Blood Plasma ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
The Body ◽  
Resistant Arterial Hypertension ◽  
The Right ◽  
Carotid Paragangliomas

Clinical case of pheochromocytoma accompanied by paraganglioma in patient with resistant arterial hypertension is presented. Pheochromocytoma/paraganglioma is the neoplasm, which produces catecholamines and consists of adrenomedullary chromaffin cells of adrenal glands or sympathic and parasympathic ganglia. Clinical course of disease depends on character and number of catecholamines which are excreted by neoplasm as well as how stable or episodic their release into the blood plasma is. Therefore, there is a persistent increase in blood pressure or hypertension has a paroxysmal (crisis) course. A feature of this clinical case is the absence of some characteristic diagnostic criteria. A targeted search was made for secondary causes of increased blood pressure despite the normal content of catecholamines in daily urine, the absence of adrenal gland changes during ultrasound. The clinical manifestations of pheochromocytoma, in addition to elevated blood pressure, were the presence of headache and palpitations. Significant weight loss by the patient over the past 1.5 years was noted which was caused by increased metabolism against the background of activation of the sympathoadrenal system. When performing duplex scanning of brachiocephalic arteries in the bifurcation region of both common carotid arteries, oval formations with clear even contours were revealed, which gave reason to suspect the atypical location of pheochromocytoma. Multispiral computed tomography with contrasting was performed of: abdominal cavity, adrenal gland, kidneys and renal arteries. In the course of the study, a rounded hypervascular formation with clear even contours was found in the body of the medial leg of the right adrenal gland. To clarify the diagnosis in the patient, the content of adrenaline and norepinephrine in the blood plasma was studied. An increase in norepinephrine by more than 4 times indicated the presence of a catecholamine-producing tumor. Thus, the diagnosis of pheochromocytoma of the right adrenal gland was confirmed and carotid paragangliomas of the neck were identified. The patient underwent laparoscopic adrenalectomy, as well as the removal of carotid paragangliomas of the neck. Doses of antihypertensive drugs were significantly reduced, blood pressure decreased to the level of 130–140/80–90 mm Hg. This clinical case illustrates the need to focus doctors on the possibility of this pathology in the absence of characteristic laboratory and instrumental abnormalities, which requires a persistent search for the causes of hypertension.

scholarly journals Arterial hypertension in a patient with non‑ specific aortoarteritis (Takayasu disease) and AA-amyloidosis: a case report

2018 ◽  
Vol 24 (3) ◽  
pp. 331-338
Author(s):  
T. S. Sveklina ◽  
A. N. Kulikov ◽  
G. K. Matsievskaya ◽  
K. R. Gustaynis
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Clinical Features ◽  
High Blood Pressure ◽  
Correct Diagnosis ◽  
Cardiovascular Disorder ◽  
Diagnostic Methods ◽  
Reactive Protein ◽  
Takayasu Disease ◽  
Chronic Course

Arterial hypertension (HTN) is the most common cardiovascular disorder around the world. High blood pressure is a manifestation of essential hypertension (EHTN) in the majority of cases. The exclusion of symptomatic HTN is crucial for correct diagnosis. We present a case of a very rare symptomatic HTN caused by nonspecific aortoarteritis (Takayasu disease). Morphological substrate of Takayasu disease is arteritis associated with the total wall damage of aortic brunches. The diagnosis is very difficult due to the chronic course, nonspecific signs and a variety of clinical masks. That often leads to late diagnosis and complications. Clinical features of Takayasu aortoarteritis include unilateral pulse weakening, blood pressure asymmetry on right and left arms, bruit on damaged artery, laboratory signs of inflammation: accelerated erythrocyte sedimentation rate (ESV), anemia, thrombocytosis, C‑reactive protein (CRP) elevation. Ultrasound vessel duplex scanning is important, but angiography of aorta and aortic branches are still the “gold standard”. We draw attention to clinical features, diagnostic methods and the course of the Takayasu disease in a young woman with high blood pressure.

scholarly journals Pseudohypertension-Like Presentation: An Exceptionally Rare Presentation in an Athletic Female Patient with Morphea

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Ahmed Al-Imam
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Traumatic Injury ◽  
Low Level Laser Therapy ◽  
Rare Presentation ◽  
Arterial Blood ◽  
First Case ◽  
Important Message ◽  
Professional Tennis ◽  
The Right

Introduction. Pseudohypertension is a condition which mainly occurs due to thickening-calcification of tunica intima of the arterial wall, leading to a faulty measurement of the intra-arterial blood pressure. To the best of our knowledge, this is the first case report in literature, of a pseudohypertension-like presentation in association with Morphea en plaque.Case Presentation. This is a rare presentation of a young athletic female and a professional tennis player, with pseudohypertension-like presentation. The patient had a traumatic injury to the right elbow joint; the injury occurred during a professional tennis match. The injury was managed by immobilization, physiotherapy, and Low-Level Laser Therapy. Soon after that, the patient had a circumscribed sclerotic ivory plaque affecting the skin of the right cubital fossa. The histopathology analysis, together with the serological-hematological tests and the clinical picture, along with positive Osler’s signs, leads to the conclusive diagnosis of Morphea en plaque. The peculiar anatomic localization of the plaque anterior to the brachial artery leads to faulty blood pressure measurement as recorded by mercurial sphygmomanometer.Conclusion. This unique presentation of Morphea en plaque carries an important message in relation to the basic medical practice and in relation to the accurate measurement of the vital signs.

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