Images
Presentation
CASE PRESENTATION: A-64-year-old male patient, presented with new-onset malignant hypertension, 13 months after an EVAR operation with CG placement to the left renal artery. [ncbi.nlm.nih.gov]
Gastrointestinal
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Nausea
One week later, he was readmitted with headache, nausea, vomiting, seizure activity, and hypertension. [ncbi.nlm.nih.gov]
[…] body, such as to the legs, the brain, the eyes and elsewhere Sudden buildup of fluid in the air sacs of the lungs ( pulmonary edema ) If you have a dangerous form of high blood pressure called malignant hypertension, symptoms can include: Bad headache Nausea [nlm.nih.gov]
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Left Flank Pain
He initially presented with gross hematuria, left flank pain, and back pain. He was observed in the hospital for 3 days and discharged. One week later, he was readmitted with headache, nausea, vomiting, seizure activity, and hypertension. [ncbi.nlm.nih.gov]
Skin
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Macula
The pathogenesis of renovascular hypertension involves the narrowing of the arteries supplying the kidneys which causes a low perfusion pressure that is detected by the juxtaglomerular apparatus (via the macula densa cells, which act as baroreceptors; [en.wikipedia.org]
Neurologic
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Headache
Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological entity characterized by variable associations of headaches, encephalopathy, seizures, vomiting, visual disturbance, and focal neurological signs. [ncbi.nlm.nih.gov]
Clinical examination showed headaches (92%), confusion (26%) and vision problems (63%). High blood pressure, and mild to moderate proteinuria were found in all cases. Hypertensive retinopathy was found in 74% of cases. [journals.lww.com]
During the year in which he was monitored, he had hypertensive emergency associated with headaches. Among the additional tests conducted, laboratory and eye fundus tests and renal ultrasound were normal. [revistanefrologia.com]
[…] in the body, such as to the legs, the brain, the eyes and elsewhere Sudden buildup of fluid in the air sacs of the lungs ( pulmonary edema ) If you have a dangerous form of high blood pressure called malignant hypertension, symptoms can include: Bad headache [nlm.nih.gov]
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Hyperactivity
Mesenchymal stem cell therapy prevented the progressive increase in systolic arterial pressure, reduced sympathetic hyperactivity, improved renal morphology, induced neovascularization and reduced fibrosis in stenotic kidneys. [ncbi.nlm.nih.gov]
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Neglect
Hypertension was diagnosed before knowing its cause in 8 neglected cases. [ncbi.nlm.nih.gov]
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Speech Disorders
MAIN FINDINGS: A 9 years old girl with primary diagnosis of NF1 combined with renovascular hypertension due to MAS, suffered of bilateral optic and chiasm glioma, pubertas praecox, speech disorder, light mental retardation and scoliosis. [ncbi.nlm.nih.gov]
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Tantrums
The symptoms included restlessness, sleep disturbances, temper tantrums, hyperactivity, aggressive behavior and attention deficit. [ncbi.nlm.nih.gov]
Workup
Based on its high accuracy reported in adults renal CT angiography (CTA) with pediatric-appropriate low radiation dose techniques has become an important tool in the workup of renovascular hypertension in children. [ncbi.nlm.nih.gov]
If study is technically accurate and Consider percutaneous angioplasty and results are reliable, no further workup If study is technically accurate and stenting. is required. results are reliable, no further workup If accuracy of study is in doubt and [slideshare.net]
Colonoscopy
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Colitis
The patient developed renal failure due to bilateral renal infarction, and died 3 months after her initial presentation with ischemic colitis. Postmortem examination confirmed the diagnosis. [ncbi.nlm.nih.gov]
Treatment
After interventional treatment, medical treatment using antihypertensive drugs was necessary in 17 of the patients. [ncbi.nlm.nih.gov]
In children with severe hypertension, it may be necessary to initiate medical treatment before a definitive diagnosis is obtained. RVHT is often refractory to medical treatment. [emedicine.medscape.com]
Prognosis
Its prognosis is favourable since atheroma or organ lesions are usually lacking. Copyright 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. [ncbi.nlm.nih.gov]
With this background, we analyzed clinical and laboratory data and determined mark prognosis survival factors in multivariate analysis by comparing the survival curves by the log-rank test. [journals.lww.com]
[…] renal artery dissection (e.g. from trauma or aortic dissection ) renal infarction Page kidney renal artery embolism or thrombosis EVAR stent graft encircling tumor (e.g. pheochromocytoma ) radiation-induced fibrosis polyarteritis nodosa Treatment and prognosis [radiopaedia.org]
Prognosis of individuals with renovascular hypertension is not easy to determine. Those with atherosclerotic renal artery disease have a high risk of mortality, furthermore those who also have renal dysfunction have a higher mortality risk. [en.wikipedia.org]
Etiology
The importance of considering prenatal as well as postnatal etiologies of acquired renovascular hypertension in neonates is emphasized. [ncbi.nlm.nih.gov]
Epidemiology
Epidemiologically, it is found mostly in female patients and is more prevalent in Asian and Latin American countries. Disease may be heterogeneous in presentation. [ncbi.nlm.nih.gov]
Epidemiology [ 3 ] The prevalence of atherosclerotic renal artery stenosis is high - about 7% in individuals older than 65 years and about 50% in patients with diffuse arterial disease, and it is increasingly frequent in an ageing population. [patient.info]
(pg. 780 - 788 ) 39 Prospective evaluation of aggressive medical therapy for atherosclerotic renal artery stenosis, with renal artery stenting reserved for previously injured heart, brain, or kidney, Am J Cardiol, 2006, vol. 96 (pg. 1322 - 1327 ) 40 Epidemiology [eurheartj.oxfordjournals.org]
Pathophysiology
The pathophysiology of renal artery stenosis is reviewed, and the pros and cons of various imaging studies in the appropriate clinical setting are discussed. [ncbi.nlm.nih.gov]
The propensity for angiotensin receptor blockers (ARBs) to affect GFR adversely is based on similar pathophysiology. [emedicine.com]
Prevention
Early diagnosis of renovascular hypertension and timely implementation of appropriate therapeutic procedures ensures optimum control of blood pressure, prevents ischemic nephropathy progression, and prevents the development of cardiovascular morbidity [ncbi.nlm.nih.gov]