scholarly journals Implantation of Covered Stent for Coarctation of the Aorta and Secondary Hypertension in Adolescents—Case Report

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1018
Author(s):  
Simina-Elena Ghiragosian-Rusu ◽  
Cristina Blesneac ◽  
Anca Sglimbea ◽  
Claudiu Ghiragosian ◽  
Laszlo Hadadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Arterial Hypertension ◽  
Coarctation Of The Aorta ◽  
Holter Monitoring ◽  
Secondary Hypertension ◽  
Covered Stent ◽  
Lower Limbs ◽  
Interventional Treatment ◽  
High Morbidity

Introduction: Coarctation of the aorta represents a narrowing of the thoracic aorta. Hypertensive patients with blood pressure differences ≥20 millimetres of mercury have an indication for surgical or interventional treatment. Implantation of a covered stent became the preferred therapy for the management of this pathology in adolescents/adults. Case report: We report the case of a 14-year-old male sportsman, who presented in the emergency room with headache, dizziness, and tinnitus. The clinical exam revealed blood pressure differences between the upper and lower limbs of up to 50 mmHg. Based on the clinical and paraclinical data, we established the diagnosis of coarctation of the aorta and severe secondary arterial hypertension. The case was discussed by a multidisciplinary team and accepted for covered stent implantation. The 24 h blood pressure Holter monitoring after the procedure indicated the persistence of stage I arterial hypertension. Conclusions: Coarctation of the aorta is a congenital cardiovascular anomaly with high morbidity and mortality rates. Arterial hypertension, heart failure, and aortic dissection are complications of this pathology, some of them being sometimes direct consequences of secondary hypertension. Periodic cardiology follow up after the procedure is mandatory to assess the hemodynamic response, to identify potential complications, and to stratify the cardiovascular risk.

Arterial hypertension + past stroke – a case report

2021 ◽  
Vol 14 (3) ◽  
pp. 324-326
Author(s):  
Maria Łukasiewicz ◽  
Marta Swarowska-Skuza
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Chronic Disease ◽  
Side Effects ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Systolic Hypertension ◽  
The Elderly ◽  
Isolated Systolic Hypertension ◽  
Special Group

Arterial hypertension, as a very widespread chronic disease, and thus differing in both pathomechanism and course in patients, requires a significant individualization of pharmacotherapy. One such special group is the elderly. Both the low-renin pathomechanism of arterial hypertension and its phenotype (isolated systolic hypertension) imply the choice of a specific pharmacotherapy. Additionally, in this group, side effects should be observed much more vigilantly, while target blood pressure values should be treated more liberally. An example of antihypertensive therapy in a patient belonging to the group described is presented in the following case.

scholarly journals The clinical case of successful combined treatment of refractory arterial hypertension. Case report

2021 ◽  
Vol 93 (9) ◽  
pp. 1086-1090
Author(s):  
Tatiana D. Solntseva ◽  
Anastasiia R. Denisova ◽  
Olga A. Sivakova ◽  
Nikolai M. Danilov ◽  
Dmitrii V. Pevzner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Renal Denervation ◽  
Clinical Case ◽  
Combined Treatment ◽  
Cardiovascular Complications ◽  
Refractory Hypertension ◽  
Clinical Variant

In recent years, there has been an increase of patients with arterial hypertension, one of the variants of which is refractory arterial hypertension. This unfavorable clinical variant of the course of hypertension worries clinicians, due to the higher risk of developing cardiovascular complications, realizing the need for a better control of blood pressure. The presented clinical case demonstrates the successful combined treatment of refractory hypertension using antihypertensive therapy and renal denervation.

scholarly journals 435 Renal denervation in a patient with uncontrolled arterial hypertension secondary to polycystic kidney disease

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Maddalena Widmann ◽  
Simone Fezzi ◽  
Gianluca Castaldi ◽  
Domenico Tavella ◽  
Michele Pighi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Chronic Pain ◽  
Kidney Disease ◽  
Arterial Hypertension ◽  
Therapeutic Option ◽  
Renal Cysts ◽  
Secondary Hypertension ◽  
Polycystic Kidney ◽  
Loin Pain

Abstract Aims Autosomal dominant polycystic kidney disease (ADPKD) represents the most common inherited cause of chronic kidney disease. Typical manifestations of this condition include secondary hypertension, abdominal pain, haematuria and urinary tract infections. Despite the progressive increase in the use of antihypertensive therapy in patients with ADPKD in the last decades, reaching blood pressure target is often difficult in this setting due to the complex physiopathology of arterial hypertension in ADPKD. Catheter-based renal sympathetic denervation (RDN) represents nowadays a therapeutic strategy to approach resistant hypertension. Based on consistent results of several sham-controlled clinical trials, the evidence of safety and efficacy of this procedure is increasing, also in patients with multiple comorbidities including chronic kidney disease. Patients with ADPKD often develop chronic severe kidney-related pain, caused by distension of the renal capsule due to the expansion of the cysts. RDN was proposed to be an effective therapeutic option able to relieve loin pain. Methods A 49-year-old man affected by ADPKD was referred to our centre for resistant uncontrolled arterial hypertension, despite combined therapy with five antihypertensive drugs. He also complained about intense loin pain and 3 years earlier underwent two surgical interventions to remove voluminous renal cysts, that did not relieve chronic pain. His kidney function was moderately decreased at presentation, with progressive decline in the previous years. After a multi-disciplinary discussion with a nephrologist and algologist, the patient was proposed for RDN with the aim of lowering blood pressure and reducing pain. He was treated in July 2018, and after the procedure, was observed a better control of blood pressure but no benefits on pain. Because of the persistence of intractable loin pain, the patient was submitted to a second RDN in December 2018. Also, after this procedure, blood pressure declined remarkably, decreasing his need for antihypertensive medications without a significant worsening of kidney function. Unfortunately, no benefit on chronic pain was observed. Results ADPKD is characterized by the progressive bilateral development of focal renal cysts. Cardiovascular complications, mainly related to hypertension, are a major cause of morbidity and mortality for these patients. RDN could be a valid and safe therapeutic option for the treatment of secondary hypertension in this setting.

scholarly journals Radiofrequency denervation of the renal arteries in patients with resistant arterial hypertension: 3 years of observation experience

2019 ◽  
Vol 16 (4) ◽  
pp. 65-69
Author(s):  
Nina Yu Savelyeva ◽  
Anna Yu Zherzhova ◽  
Ekaterina V Mikova ◽  
Liudmila I Gapon ◽  
Grigorii V Kolunin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Secondary Hypertension ◽  
Renal Arteries ◽  
Radiofrequency Denervation ◽  
Intact Kidney ◽  
Resistant Arterial Hypertension

Objective. To evaluate the efficiency of radiofrequency denervation of the renal arteries in patients with resi-stant arterial hypertension during a three-year follow-up. Materials and methods. The study involved 40 patients with resistant arterial hypertension aged 27 to 70 years (mean age 54.91±9.77 years) while receiving three or more antihypertensive drugs (including diuretic) in optimal doses. The conditions for inclusion in the study were considered resistant arterial hypertension with blood pressure (BP)>160/100 mm Hg, intact kidney function - glomerular filtration rate (MDRD)>45 ml/min - and the absence of secondary hypertension. All patients had sympatic radiofrequency denervation of renal arteries; its efficiency later was estimated according to the clinical measurement and ambulatory blood pressure monitoring (ABPM). Results. The level of office BP reliably differed initially and after 3 years: DSBP -34.48±6.44 mm Hg (p=0.001), DDBP - 22.29 mm Hg (p=0.001). According to ABPM results, reliable dynamics of systolic blood pressure was not observed. The data of DBP at night were significantly lower after 36 months; DDBP was -5.37±9.77 mm Hg. Conclusions. A marked decrease in the data of office SBP and DBP was observed, which proves the long-term efficiency of radiofrequency denervation of the renal arteries in patients with resistant hypertension. Accor-ding to ABPM results after 36 months, a significant decrease was registered among the DBP indicators at night and daytime.

scholarly journals Pheochromocytoma: A Rare Cause of Secondary Hypertension

2013 ◽  
Vol 1 (1) ◽  
pp. 48
Author(s):  
Sahadeb Prasad Dhungana ◽  
G P Acharya ◽  
R M Piryani ◽  
S K Shrestha
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Antihypertensive Drugs ◽  
Hypertensive Crisis ◽  
Frozen Shoulder ◽  
Case Series ◽  
Secondary Hypertension ◽  
Catecholamine Excess ◽  
Contrast Enhanced Ct ◽  
Adrenal Pheochromocytoma

  Introduction: Pheochromocytoma is a rare tumor, originating from the chromaffin tissue. Its frequency is approximately 1/100,000. The clinical manifestation is due to catecholamine excess, which includes high blood pressure, palpitation, headache, sweating, nausea, vomiting, trembling, weakness, irritation, abdominal and chest pain, dyspnea, red warm face, constipation, polyuria, and polydipsia.   Case Report: We present a case of 53 years old male, hospitalized for hypertensive crisis following the manipulation of left sided frozen shoulder. He had labile blood pressure ranging from 220/120 systolic- 90/60 diastolic, profuse sweating and tachycardia. Findings of Contrast enhanced CT of abdomen was consistent with right adrenal pheochromocytoma and 24 hours urinary VMA was 17 mg /24 hr (Normal <13.6 mg /24hr). After the clinical, paraclinical investigations and radiological tests, it was proved to be a pheochromocytoma. The surgical intervention was planned. But due to unavailability of required antihypertensive drugs in Nepal (alpha-blockers like phentolamine and phenoxybenzamine), surgeons were reluctant to operate, although blood pressure was well controlled with use of sodium nitroprusside during hypertensive crisis and prazosin, a selective alpha blocker as maintainance therapy. The use of prazosin to control hypertension secondary to pheochromocytoma is limited to case report and case series.   Conclusion: Although rare, pheochromocytoma is a treatable surgical cause of secondary hypertension.

scholarly journals Significance/role of family medicine physicians in early detection of secondary hypertension

2021 ◽  
Vol 26 (83) ◽  
pp. 71-82
Author(s):  
Marijana Jandrić-Kočič ◽  
Snežana Knežević
Keyword(s):  
Blood Pressure ◽  
Early Detection ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Left Kidney ◽  
Secondary Hypertension ◽  
Left Ventricular ◽  
Levothyroxine Sodium ◽  
Thyroid Peroxidase ◽  
Dietary Regimen

SUMMARY - Introduction: Secondary arterial hypertension has an identifiable underlying cause. Routine screening is not indicated given the low prevalence of the disease (5-10% arterial hypertension), longterm and costly diagnostic evaluation. Case report: An outpatient family medication presents a 34-year-old patient due to worsening, by then stable, arterial hypertension. She was found 12 months ago when reported to a private healthcare facility where she was allowed perindopril / amlodipine 4/5 mg, 1x1 tablet. So far healthy, it negates diseases of relevance to inheritance. Smoker. 24hour outpatient blood pressure monitoring checks for elevated diastolic blood pressure levels in 59,3% of measurements during the day and 59,2% of measurements during the night. Thyroid ultrasound checks for inhomogeneous structure, right flap 40x15x16 mm, left flap 42x15x16 mm. Abdominal ultrasound reduces left kidney, bilateral thinning cortex, left ventricular moderate hydronephrosis. The laboratory contains large amounts of tyrosimulating hormone as well as antibodies to thyroid peroxidase, decreased levels of free thyroxine and a slight increase in albumin in 24 hours of urine. The patient is referred for a consultative examination by a nephrologist and a nuclear medicine specialist. Same indicative hygiene dietary regimen and introduction of levothyroxine sodium tablets 100 mcg 1x 1 ¼ tablets (125 mcg). Antihypertensive therapy was discontinued at most months later, while levothyroxine sodium replacement therapy was reduced to 1 x 100 mcg. Conclusion: The work of a selected family physician in accordance with good clinical practice guidelines allows for the early detection, normalization or increase in the number of secondary hypertension, the reduction of the possibility of accommodation of irreversible changes in blood vessels, and coexisting essential hypertension.

Secondary causes of hypertension

ESC CardioMed ◽  
2018 ◽  
pp. 2409-2419
Author(s):  
Isabella Sudano ◽  
Felix Beuschlein ◽  
Thomas F. Lüscher
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Arterial Hypertension ◽  
Late Onset ◽  
Young Patients ◽  
Secondary Hypertension ◽  
Clinical Findings ◽  
Age Group ◽  
History Of ◽  
Secondary Causes

Secondary hypertension may be defined as a type of hypertension (i.e. blood pressure >140/90 mmHg) with an underlying, potentially correctable cause. Secondary hypertension should be particularly considered in (1) young patients without a family history of arterial hypertension, (2) patients with resistant hypertension, and (3) late onset of hypertension. In addition to the medical history, a secondary aetiology may be suspected in the presence of symptoms (e.g. flushing and sweating suggestive of phaeochromocytoma), clinical findings (e.g. a renal bruit suggestive of renal artery stenosis), or laboratory abnormalities (e.g. hypokalaemia suggestive of hyperaldosteronism). Approximately 5% of adults with hypertension have a secondary cause. The prevalence of secondary hypertension and the most common aetiologies vary by age group. This chapter aims to summarize the principal causes of secondary hypertension, how these may be diagnosed and their specific treatments.

scholarly journals Antihypertensive treatment with telmisartan in a cat with amlodipine-induced gingival hyperplasia

2017 ◽  
Vol 3 (2) ◽  
pp. 205511691774523 ◽  
Author(s):  
Lien Desmet ◽  
Jeroen van der Meer
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Arterial Hypertension ◽  
Antihypertensive Drug ◽  
Antihypertensive Treatment ◽  
Published Data ◽  
Gingival Hyperplasia ◽  
Middle Aged ◽  
Systemic Arterial Hypertension ◽  
Case Summary

Case summary Systemic arterial hypertension is commonly reported in middle-aged-to-older cats. Amlodipine is recommended as the initial antihypertensive drug in cats. In this case report, gingival hyperplasia secondary to the use of amlodipine in a cat is described. Benazepril as a monotherapy was unsuccessful in reducing blood pressure in this cat. After replacement of benazepril by telmisartan, gingival hyperplasia disappeared and blood pressure was well controlled. Relevance and novel information This case report describes the first reported case of reversible gingival hyperplasia as a result of the treatment with amlodipine. It also contains the first published data on the effect of telmisartan in a hypertensive cat.

scholarly journals Posaconazole aggravates vincristine-related hypertension in children with acute lymphoblastic leukemia: a case report

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096957
Author(s):  
Chao Lin ◽  
Guohua Chen ◽  
Junbin Huang ◽  
Yucai Cheng ◽  
Yahong Xu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Adverse Event ◽  
Case Report ◽  
Acute Lymphoblastic Leukemia ◽  
Antihypertensive Treatment ◽  
Fungal Infections ◽  
Lymphoblastic Leukemia ◽  
Secondary Hypertension ◽  
Rare Occurrence ◽  
Hypertension In Children

Vincristine-related secondary hypertension is rare. This study reports two children who were treated with vincristine for acute lymphoblastic leukemia (ALL) and posaconazole for fungal infections who experienced vincristine-related secondary hypertension. Blood pressure normalized in both children after halting the drugs and providing antihypertensive treatment. Thus, posaconazole can interact with vincristine and induce secondary hypertension in children with ALL. As an adverse event, this interaction is a rare occurrence.

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