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Refractory hypertension and the lower limbs ischaemia as an aortic coarctation symptom
Affiliations- Department of Internal Medicine, 4th Military Teaching Hospital, Wroclaw, Poland
- Division of Angiology, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
- Department of Hygiene, Wroclaw Medical University, Wroclaw, Poland
- Department of Radiology and Diagnostic Imaging, 4th Military Hospital, Wroclaw, Poland
- Department of Congenital Heart Diseases and Paediatric Cardiology, Silesian Centre for Heart Diseases, Medical University of Silesia, Zabrze, Poland
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Abstract
Coarctation of the aorta (CoA) is a very rare cause of secondary hypertension, accounting for 0.1% of cases. The
coarctation can present at any age. Hypertension is the most common presenting symptom. All patients with newly
diagnosed hypertension must have a physical examination with assessment of the brachial and femoral pulses and
measurement of brachial and popliteal blood pressures. A thorough physical examination is a crucial first step in
diagnosing aortic coarctation.
Abstract
Coarctation of the aorta (CoA) is a very rare cause of secondary hypertension, accounting for 0.1% of cases. The
coarctation can present at any age. Hypertension is the most common presenting symptom. All patients with newly
diagnosed hypertension must have a physical examination with assessment of the brachial and femoral pulses and
measurement of brachial and popliteal blood pressures. A thorough physical examination is a crucial first step in
diagnosing aortic coarctation.
Keywords
hypertension; aortic coarctation; ABI; lower limb ischaemia
About this articleTitle
Refractory hypertension and the lower limbs ischaemia as an aortic coarctation symptom
Journal
Issue
Article type
Case report
Pages
35-39
Published online
2019-02-22
Page views
656
Article views/downloads
749
DOI
Bibliographic record
Arterial Hypertension 2019;23(1):35-39.
Keywords
hypertension
aortic coarctation
ABI
lower limb ischaemia
Authors
Katarzyna Drożdż
Angelika Chachaj
Paweł Gać
Roland Fiszer
Jacek Białkowski
Andrzej Szuba
References (20)- Iuliano L, Micheletta F, Natoli S, et al. Aortic coarctation in the elderly: how many errors lie behind an unexpected diagnosis? Intern Emerg Med. 2007; 2(3): 207–209.
- Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). Circulation. 2008; 118(23): 2395–2451.
- Narin N, Onan SH, Baykan A, et al. Transcatheter antegrade perforation and covered stent implantation to subatretic coarctation. Anadolu Kardiyol Derg. 2012; 12(5): 442–443.
- Sreeram N, DeGiovanni J. Stent implantation for coarctation facilitated by the antegrade trans-septal approach. Images Paediatr Cardiol. 2005; 7(1): 12–17.
- Tzifa A, Ewert P, Brzezinska-Rajszys G, et al. Covered Cheatham-platinum stents for aortic coarctation: early and intermediate-term results. J Am Coll Cardiol. 2006; 47(7): 1457–1463.
- Ohlow MA, Lauer B. Coarctation of aorta with complete aortic occlusion. J Geriatr Cardiol. 2013; 10(4): 383–385.
- Cohen M, Fuster V, Steele PM, et al. Coarctation of the aorta. Long-term follow-up and prediction of outcome after surgical correction. Circulation. 1989; 80(4): 840–845.
- Bernier PL, Stefanescu A, Samoukovic G, et al. The challenge of congenital heart disease worldwide: epidemiologic and demographic facts. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2010; 13(1): 26–34.
- Anderson RH, Lenox CC, Zuberbuhler JR. Morphology of ventricular septal defect associated with coarctation of aorta. Br Heart J. 1983; 50(2): 176–181.
- Shinebourne EA, Tam AS, Elseed AM, et al. Coarctation of the aorta in infancy and childhood. Br Heart J. 1976; 38(4): 375–380.
- Becker AE, Becker MJ, Edwards JE. Anomalies associated with coarctation of aorta: particular reference to infancy. Circulation. 1970; 41(6): 1067–1075.
- Curtis SL, Bradley M, Wilde P, et al. Results of screening for intracranial aneurysms in patients with coarctation of the aorta. AJNR Am J Neuroradiol. 2012; 33(6): 1182–1186.
- Rosenthal E. Coarctation of the aorta from fetus to adult: curable condition or life long disease process? Heart. 2005; 91(11): 1495–1502.
- Ward KE, Pryor RW, Matson JR, et al. Delayed detection of coarctation in infancy: implications for timing of newborn follow-up. Pediatrics. 1990; 86(6): 972–976.
- Liberman RF, Getz KD, Lin AE, et al. Delayed diagnosis of critical congenital heart defects: trends and associated factors. Pediatrics. 2014; 134(2): e373–e381.
- Strafford MA, Griffiths SP, Gersony WM. Coarctation of the aorta: a study in delayed detection. Pediatrics. 1982; 69(2): 159–163.
- Mancia G, Fagard R, Narkiewicz K, et al. Task Force Members. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31(7): 1281–1357.
- Luijendijk P, Bouma BJ, Groenink M, et al. Surgical versus percutaneous treatment of aortic coarctation: new standards in an era of transcatheter repair. Expert Rev Cardiovasc Ther. 2012; 10(12): 1517–1531.
- Sulik S, Fiszer R, Scalone G, et al. Immediate and long‑term outcomes of native aortic coarctation and postsurgical aortic recoarctation treated with stent implantation: a single‑center experience. Pol Arch Intern Med. 2017; 127(7–8): 498–505.
- Szkutnik M, Sulik S, Fiszer R, et al. Native aortic coarctation stenting in patients ≥ 46 years old. Postepy Kardiol Interwencyjnej. 2017; 13(4): 302–306.