open access

Vol 25, No 1 (2021)
Case report
Published online: 2021-03-22
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Primary aldosteronism and coronary-pulmonary artery fistula: coincidence or causal link? A case report and literature review

Luigi Marzano
DOI: 10.5603/AH.a2021.0006
·
Arterial Hypertension 2021;25(1):47-52.

open access

Vol 25, No 1 (2021)
CASE REPORT
Published online: 2021-03-22

Abstract

Background: Primary aldosteronism (PA) is the most frequent form of potentially reversible hypertension and
coronary-pulmonary fistulas are increasingly recognized during routine coronary angiography or multidetector computed
tomography for analysis of chest pain in hypertensive patients. Aldosterone hypersecretion has been associated
with endothelial proliferation and pathological remodeling of the heart and arteries, though coronary artery fistulas
have never been reported in patients with PA.

Case presentation: The authors report the first case of PA with dilated cardiomyopathy unusually associated with
electrocardiographic changes after normalization of hypokalemia and with the finding of a coronary-pulmonary
fistula during coronary angiography. The clinical presentation and our diagnosis and treatment decision-making in
the COVID-19 era are discussed below.

Conclusions: Our case suggests a potential link between hypertensive patients with coronary artery fistulas and PA.

Abstract

Background: Primary aldosteronism (PA) is the most frequent form of potentially reversible hypertension and
coronary-pulmonary fistulas are increasingly recognized during routine coronary angiography or multidetector computed
tomography for analysis of chest pain in hypertensive patients. Aldosterone hypersecretion has been associated
with endothelial proliferation and pathological remodeling of the heart and arteries, though coronary artery fistulas
have never been reported in patients with PA.

Case presentation: The authors report the first case of PA with dilated cardiomyopathy unusually associated with
electrocardiographic changes after normalization of hypokalemia and with the finding of a coronary-pulmonary
fistula during coronary angiography. The clinical presentation and our diagnosis and treatment decision-making in
the COVID-19 era are discussed below.

Conclusions: Our case suggests a potential link between hypertensive patients with coronary artery fistulas and PA.

Get Citation

Keywords

aldosterone; cardiomyopathy; coronary-pulmonary fistula; hyperaldosteronism; hypertension; ECG

About this article
Title

Primary aldosteronism and coronary-pulmonary artery fistula: coincidence or causal link? A case report and literature review

Journal

Arterial Hypertension

Issue

Vol 25, No 1 (2021)

Article type

Case report

Pages

47-52

Published online

2021-03-22

DOI

10.5603/AH.a2021.0006

Bibliographic record

Arterial Hypertension 2021;25(1):47-52.

Keywords

aldosterone
cardiomyopathy
coronary-pulmonary fistula
hyperaldosteronism
hypertension
ECG

Authors

Luigi Marzano

References (20)
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