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.

Mid-Aortic Syndrome: A Rare Cause of Renovascular Hypertension in Childhood Treated Percutaneously with an Unusual Vascular Access

2020 ◽  
Vol 16 ◽  
Author(s):  
Emma Diletta Stea ◽  
Giovanni Meliota ◽  
Vincenza Carbone ◽  
Giuseppina Annicchiarico ◽  
Diletta Torres ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renovascular Hypertension ◽  
Clinical Symptoms ◽  
Axillary Artery ◽  
Vascular Malformations ◽  
Organ Damage ◽  
Hypertensive Encephalopathy ◽  
Left Ventricular ◽  
Femoral Access ◽  
Renal Angioplasty

Introduction: Mid-Aortic Syndrome (MAS) is a rare vascular malformation characterized by segmental narrowing of the abdominal aorta and stenosis of its principal branches. Patients affected by MAS typically present malignant renovascular hypertension, with variable clinical symptoms like claudication, abdominal angina and headache. Moreover, they can develop complications such as hypertensive encephalopathy, congestive heart failure and vascular brain accidents. Hypertension with MAS is often resistant to multidrug therapy, requiring a surgical approach to treat the clinical symptoms, prevent or block organ damage and normalize the blood pressure. Casereport: Here we report the case of a 4-year-old boy showing elevated blood pressure with left ventricular hypertrophy leading to idiopathic MAS, who was successfully treated with percutaneous transcatheter renal angioplasty (PTRA) using an unusual, anterograde access. Discussion and Conclusions: In children and adolescents, vascular malformations like MAS must be considered as a possible cause of hypertension. PTRA is a successful therapeutic strategy in children with severe renovascular hypertension. Anterograde access using an axillary artery can be a valid approach for PTRA when femoral access is difficult to achieve.

HEART COMPLICATIONS IN HYPERTHYROIDISM

2011 ◽  
pp. 7-17
Author(s):  
Hai Thuy Nguyen ◽  
Anh Vu Nguyen
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Heart Rate ◽  
Heart Diseases ◽  
Systolic Dysfunction ◽  
Oxygen Demand ◽  
Left Ventricular ◽  
Cardiac Contraction ◽  
Cardiac Complications ◽  
Cardiac Symptoms

Thyroid hormone increases the force of the contraction and the amount of the heart muscle oxygen demand. It also increases the heart rate. Due to these reasons, the work of the heart is greatly increased in hyperthyroidism. Hyperthyroidism increases the amount of nitric oxide in the intima, lead them to be dilated and become less stiff. Cardiac symptoms can be seen in anybody with hyperthyroidism, but can be particularly dangerous in whom have underlying heart diseases. Common symptoms include: tachycardia and palpitations. Occult hyperthyroidism is a common cause of an increased heart rate at rest and with mild exertion. Hyperthyroidism can also produce a host of other arrhythmias such as PVCs, ventricular tachycardia and especially atrial fibrillation. Left ventricular diastolic dysfunction and systolic dysfunction, Mitral regurgitation and mitral valve prolapsed are heart complications of hyperthyroism could be detected by echocardiography. The forceful cardiac contraction increases the systolic blood pressure despite the increased relaxation in the blood vessels reduces the diastolic blood pressure. Atrial fibrillation, atrial enlargement and congestive heart failure are important cardiac complications of hyperthyroidism. An increased risks of stroke is common in patients with atrial fibrillation. Graves disease is linked to autoimmune complications, such as cardiac valve involvement, pulmonary arterial hypertension and specific cardiomyopathy. Worsening angina: Patients with coronary artery disease often experience a marked worsening in symptoms with hyperthyroidism. These can include an increase in chest pain (angina) or even a heart attack.

scholarly journals The Capabilities of Amlodipine/Lisinopril Single-Pill Combination in the Treatment of Newly Diagnosed Arterial Hypertension in a Middle-Aged Patient (Case Report)

2020 ◽  
Vol 16 (2) ◽  
pp. 221-230
Author(s):  
A. I. Kochetkov ◽  
M. V. Lopukhina ◽  
E. A. Kotaeva ◽  
A. A. Kirichenko ◽  
O. D. Ostroumova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Left Ventricular ◽  
Favorable Effect ◽  
Newly Diagnosed ◽  
Functional Changes ◽  
Collagen Formation ◽  
Cardiovascular Morbidity And Mortality ◽  
Single Pill ◽  
Left Atrial Stiffness

Arterial hypertension (AH) is one of the most significant modifiable risk factors that increase cardiovascular morbidity and mortality worldwide, including Russia. The complex of structural and functional changes in the heart that occurs during AH consists not only in the formation of left ventricular (LV) myocardial hypertrophy, but also in the myocardial stiffness increasing due to collagen formation and cardiomyocytes apoptosis. These abnormalities are substrate for diastolic function disturbances, electrical myocardial instability and ischemia. The article provides a clinical case of amlodipine/lisinopril single-pill combination (A/L SPC) use in real clinical practice in a patient with stage II grade 2 newly diagnosed AH and its effect on blood pressure and echocardiographic myocardial fibrosis markers, including speckle tracking parameters The high antihypertensive efficacy of A/L SPC, a favorable effect on blood pressure circadian rhythm, as well as pronounced target-organ protective properties, in particular the ability to reduce LV and left atrial stiffness, were demonstrated. So, we conclude that A/L SPC improve the elastic properties of the left heart.

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.

Initial left-ventricular mass predicts probability of uncontrolled blood pressure in arterial hypertension

2011 ◽  
Vol 29 (4) ◽  
pp. 803-808 ◽  
Author(s):  
Raffaele Izzo ◽  
Giovanni de Simone ◽  
Richard B Devereux ◽  
Renata Giudice ◽  
Marina De Marco ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Left Ventricular Mass ◽  
Left Ventricular ◽  
Uncontrolled Blood Pressure ◽  
Ventricular Mass

scholarly journals Cushing’s Disease: Assessment of Early Cardiovascular Hemodynamic Dysfunction With Impedance Cardiography

2021 ◽  
Vol 12 ◽  
Author(s):  
Agnieszka Jurek ◽  
Paweł Krzesiński ◽  
Grzegorz Gielerak ◽  
Przemysław Witek ◽  
Grzegorz Zieliński ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Cushing’S Disease ◽  
Impedance Cardiography ◽  
Left Ventricular ◽  
Cushing's Disease ◽  
Control Group ◽  
Stroke Index ◽  
Disease Group ◽  
Hemodynamic Assessment

BackgroundCushing’s disease is a rare condition associated with a high cardiovascular risk and hypercortisolemia-related hemodynamic dysfunction, the extent of which can be assessed with a noninvasive method, called impedance cardiography. The standard methods for hemodynamic assessment, such as echocardiography or ambulatory blood pressure monitoring may be insufficient to fully evaluate patients with Cushing’s disease; therefore, impedance cardiography is being currently considered a new modality for assessing early hemodynamic dysfunction in this patient population. The use of impedance cardiography for diagnosis and treatment of Cushing’s disease may serve as personalized noninvasive hemodynamic status assessment and provide a better insight into the pathophysiology of Cushing’s disease. The purpose of this study was to assess the hemodynamic profile of Cushing’s disease patients and compare it with that in the control group.Material and MethodsThis observational prospective clinical study aimed to compare 54 patients with Cushing’s disease (mean age 41 years; with 64.8% of this population affected with arterial hypertension) and a matched 54-person control group (mean age 45 years; with 74.1% of this population affected with arterial hypertension). The hemodynamic parameters assessed with impedance cardiography included the stroke index (SI), cardiac index (CI), systemic vascular resistance index (SVRI), velocity index (VI), (ACI), Heather index (HI), and thoracic fluid content (TFC).ResultsThe Cushing’s disease group was characterized by a higher diastolic blood pressure and a younger age than the control group (82.9 vs. 79.1 mmHg, p=0.045; and 41.1 vs. 44.9 years, p=0.035, respectively). Impedance cardiography parameters in the Cushing’s disease group showed: lower values of SI (42.1 vs. 52.8 ml/m2; p ≤ 0.0001), CI (2.99 vs. 3.64 l/min/m2; p ≤ 0,0001), VI (42.9 vs. 52.1 1/1000/s; p=0.001), ACI (68.7 vs. 80.5 1/100/s2; p=0,037), HI (13.1 vs. 15.2 Ohm/s2; p=0.033), and TFC (25.5 vs. 27.7 1/kOhm; p=0.006) and a higher SVRI (2,515 vs. 1,893 dyn*s*cm-5*m2; p ≤ 0.0001) than those in the control group.ConclusionsCushing’s disease is associated with significantly greater vasoconstriction and left ventricular systolic dysfunction. An individual assessment with impedance cardiography may be useful in Cushing’s disease patients in order to identify subclinical cardiovascular complications of chronic hypercortisolemia as potential therapeutic targets.

scholarly journals Arterial hypertension: Modern problems

2017 ◽  
Vol 95 (7) ◽  
pp. 581-585
Author(s):  
Igor N. Bokarev ◽  
P. A. Dulin ◽  
Yu. V. Ovchinnikov ◽  
V. B. Simonenko
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Hypertensive Crisis ◽  
Elevated Blood ◽  
Pressure Monitoring ◽  
Hypertensive Disease ◽  
Early Stages ◽  
Hypertensive Crises

Arterial hypertension (AH) is one of the most common diseases. Despite numerous studies, many problems related to this pathology remain to be elucidated. The modern classifications of AHare contradictory and true causes of elevated blood pressure (BP) are unknown. There are no methods for diagnostics of early stages of AH nor is there adequateunderstanding of what hypertensive crises are, how they are to be classified and why they develop. Pathomorphosis of AH is practically unexplored. There are no efficient medications and therapies for the radical treatment of AH. The authors propose classification of hypertensive crisis, hypertensive disease, and symptomatic AH. It is recommended to use 24-hour blood pressure monitoring in all AH patients. New approaches to diagnostics of early stages of AH are proposed.

scholarly journals No association of the CYP3A5*1 allele with blood pressure and left ventricular mass and geometry: the KORA/MONICA Augsburg echocardiographic substudy

2006 ◽  
Vol 111 (6) ◽  
pp. 365-372 ◽  
Author(s):  
Wolfgang Lieb ◽  
Juliane Bolbrinker ◽  
Angela Döring ◽  
Hans-Werner Hense ◽  
Jeanette Erdmann ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Left Ventricular Mass ◽  
Posterior Wall ◽  
Pressure Control ◽  
Population Based ◽  
Left Ventricular ◽  
Genotype Distribution ◽  
Cytochrome P450 3A ◽  
Ventricular Mass

A polymorphism in the cytochrome P450 3A CYP3A5 enzyme has been implicated in BP (blood pressure) control and arterial hypertension. Carriers of the CYP3A5*1 allele had high, whereas homozygous carriers of the CYP3A5*3 allele exhibit low, CYP3A5 expression in the kidney, where CYP3A5 represents the major CYP3A enzyme. The aim of the present study was to investigate the association of the CYP3A5*1 allele with BP, arterial hypertension, LVM [(left ventricular) mass] and LV geometry in a large Caucasian-population-based cohort. We compared BP, LVM and the prevalence of hypertension between carriers (CYP3A5*1/*1 and CYP3A5*1/*3 genotypes) and non-carriers (CYP3A5*3/*3 genotype) of the CYP3A5*1 allele in the echocardiographic substudy of the third MONICA (MONItoring trends and determinants in CArdiovascular disease) Augsburg survey. After exclusion of 269 individuals who were taking antihypertensive medication, 530 women and 554 men were available for analysis, revealing allele frequencies of 5.8 and 94.2% for the CYP3A5*1 and CYP3A5*3 alleles respectively. Overall, the presence of the CYP3A5*1 allele exhibited no effect on systolic or diastolic BP in either gender. One-third of the individuals in this cohort were hypertensive (BP ≥140/90 mmHg), and the genotype distribution between normotensive and hypertensive individuals revealed no association between CYP3A5*1 and hypertension after adjustment for age, BMI and gender (odds ratio, 1.02; P=0.92). Moreover, no effect of CYP3A5*1 on LVM, thickness of the septal and posterior wall and LV end-diastolic diameter was found. We conclude that CYP3A5*1 exhibits no significant effect on BP, LVM and LV geometry in the KORA/MONICA echocardiographic substudy.

scholarly journals Glycopenia - induced sympathoadrenal activation in diabetes mellitus and uncontrolled arterial hypertension: an observational study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Abimbola Abobarin-Adeagbo ◽  
Andreas Wienke ◽  
Matthias Girndt ◽  
Rainer U. Pliquett
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Insulin Dose ◽  
Hypertensive Crisis ◽  
Plasma Norepinephrine ◽  
Arterial Blood ◽  
Group 3 ◽  
Group 2 ◽  
Group 1 ◽  
Diabetes Patients

Abstract Background Aim of this study is to investigate a possible association of hypoglycemic episodes and arterial hypertension. We hypothesize that hospitalized insulin-treated diabetes patients with hypertensive crisis have more hypoglycemic episodes than their counterparts without hypertensive crisis on admission. Methods In a prospective, observational cohort study, 65 insulin-treated diabetes patients (type 1, type 2, type 3c) were included in Group 1, when a hypertensive crisis was present, as control patients in Group 2 without hypertensive crisis or hypoglycemia, in Group 3, when a symptomatic hypoglycemia was present on admission. All patients were subjected to open-label continuous glucose monitoring, 24-h blood-pressure- and Holter electrocardiogram recordings, and to laboratory tests including plasma catecholamines. Results 53 patients, thereof 19 Group-1, 19 Group-2, 15 Group-3 patients, completed this study. Group-1 patients had the highest maximum systolic blood pressure, a higher daily cumulative insulin dose at admission, a higher body-mass index, and a higher plasma norepinephrine than control patients of Group 2. Group-3 patients had more documented hypoglycemic episodes (0.8 ± 0.5 per 24 h) than Group-2 patients (0.2 ± 0.3 per 24 h), however, they were not different to the ones in Group-1 patients (0.4 ± 0.4 per 24 h). Plasma norepinephrine and mean arterial blood pressure were higher Group-1 and Group-3 patients than in control patients of Group 2. At discharge, the daily cumulative insulin dose was reduced in Group-1 (− 18.4 ± 24.9 units) and in Group-3 patients (− 18.6 ± 22.7 units), but remained unchanged in Group-2 control patients (− 2.9 ± 15.6 units). Conclusions An association between hypoglycemic events and uncontrolled hypertension was found in this study.

scholarly journals Takotsubo Syndrome in Patients with COVID-19: a Systematic Review of Published Cases

2020 ◽  
Vol 2 (11) ◽  
pp. 2102-2108 ◽  
Author(s):  
Sandeep Singh ◽  
Rupak Desai ◽  
Zainab Gandhi ◽  
Hee Kong Fong ◽  
Shriya Doreswamy ◽  
...  
Keyword(s):  
Case Reports ◽  
Hypertensive Crisis ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cardiac Complications ◽  
Time Interval ◽  
Takotsubo Syndrome ◽  
Ventricular Ejection Fraction ◽  
Successful Recovery

AbstractTakotsubo syndrome (TTS) is caused by catecholamine surge, which is also observed in COVID-19 disease due to the cytokine storm. We performed a systematic literature search using PubMed/Medline, SCOPUS, Web of Science, and Google Scholar databases to identify COVID-19-associated TTS case reports and evaluated patient-level demographics, clinical attributes, and outcomes. There are 12 cases reported of TTS associated with COVID-19 infection with mean age of 70.8 ± 15.2 years (range 43–87 years) with elderly (66.6% > 60 years) female (66.6%) majority. The time interval from the first symptom to TTS was 8.3 ± 3.6 days (range 3–14 days). Out of 12 cases, 7 reported apical ballooning, 4 reported basal segment hypo/akinesia, and 1 reported median TTS. Out of 12 cases, during hospitalization, data on left ventricular ejection fraction (LVEF) was reported in only 9 of the cases. The mean LVEF was 40.6 ± 9.9% (male, 46.7 ± 5.7%, and female, 37.7 ± 10.6%). Troponin was measured in all 12 cases and was elevated in 11 (91.6%) without stenosis on coronary angiography except one. Out of 11 cases, 6 developed cardiac complications with 1 case each of cardiac tamponade, heart failure, myocarditis, hypertensive crisis, and cardiogenic shock in 2. Five patients required intubation, 1 patient required continuous positive airway pressure, and 1 patient required venovenous extracorporeal membrane oxygenation. The outcome was reported in terms of recovery in 11 (91.6%) out of 12 cases, and a successful recovery was noted in 10 (90.9%) cases. COVID-19-related TTS has a higher prevalence in older women. Despite a lower prevalence of cardiac comorbidities in COVID-19 patients, direct myocardial injury, inflammation, and stress may contribute to TTS with a high complication rate.

Sign in / Sign up

Export Citation Format

Share Document