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Primary aldosteronism and coronary-pulmonary artery fistula: coincidence or causal link? A case report and literature review
Affiliations- Internal Medicine Unit, St. Bortolo General Hospital, Vincenza — Veneto Region, Italy, Italy
open access
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.
Keywords
aldosterone; cardiomyopathy; coronary-pulmonary fistula; hyperaldosteronism; hypertension; ECG
About this articleTitle
Primary aldosteronism and coronary-pulmonary artery fistula: coincidence or causal link? A case report and literature review
Journal
Issue
Article type
Case report
Pages
47-52
Published online
2021-03-22
Page views
523
Article views/downloads
562
DOI
Bibliographic record
Arterial Hypertension 2021;25(1):47-52.
Keywords
aldosterone
cardiomyopathy
coronary-pulmonary fistula
hyperaldosteronism
hypertension
ECG
Authors
Luigi Marzano
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