A Complicated Case of Resistant Hypertension
A 47-year-old woman presented with a history of resistant arterial hypertension, associated with disabling headache. She was subjected to an enormous number of tests in order to identify an underlying cause of secondary hypertension, such as pheochromocytoma or Cushing syndrome, but all the most co...
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Tehran University of Medical Sciences
2017-10-01
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doaj-6cacb55200d44f6f946fd0fc0e71f1642020-11-25T02:51:49ZengTehran University of Medical SciencesActa Medica Iranica0044-60251735-96942017-10-015585195A Complicated Case of Resistant HypertensionMauro Chiarito0Andrea Scotti1Carlo A Pivato2Giuseppe Cottone3Carlo Ballarotto4Cosmo Godino5Alberto Margonato6Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy.Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy.Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy.Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy.Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy.Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy.Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy. A 47-year-old woman presented with a history of resistant arterial hypertension, associated with disabling headache. She was subjected to an enormous number of tests in order to identify an underlying cause of secondary hypertension, such as pheochromocytoma or Cushing syndrome, but all the most common causes of secondary hypertension were investigated and gradually excluded. Factitious use of amphetamine or cocaine was excluded, and therapy compliance was verified by witnessed ingestion of drug therapy, in order to rule out Munchausen syndrome. The patient underwent a first transcatheter renal denervation (RDN) with poor effect on blood pressure (BP) at long term follow up. Because of extremely poor control of BP values, a second RDN was performed two years later, again with inadequate long term efficacy. Despite an uncontrollable pre-procedural BP, RDN had an excessive BP lowering effect in this patient, but only for few months. In conclusion, a definitive diagnosis was not performed in our patient, despite an extremely deepened examination of the most common cause of refractory hypertension. https://acta.tums.ac.ir/index.php/acta/article/view/5444HypertensionRefractory hypertensionRenal denervation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mauro Chiarito Andrea Scotti Carlo A Pivato Giuseppe Cottone Carlo Ballarotto Cosmo Godino Alberto Margonato |
spellingShingle |
Mauro Chiarito Andrea Scotti Carlo A Pivato Giuseppe Cottone Carlo Ballarotto Cosmo Godino Alberto Margonato A Complicated Case of Resistant Hypertension Acta Medica Iranica Hypertension Refractory hypertension Renal denervation |
author_facet |
Mauro Chiarito Andrea Scotti Carlo A Pivato Giuseppe Cottone Carlo Ballarotto Cosmo Godino Alberto Margonato |
author_sort |
Mauro Chiarito |
title |
A Complicated Case of Resistant Hypertension |
title_short |
A Complicated Case of Resistant Hypertension |
title_full |
A Complicated Case of Resistant Hypertension |
title_fullStr |
A Complicated Case of Resistant Hypertension |
title_full_unstemmed |
A Complicated Case of Resistant Hypertension |
title_sort |
complicated case of resistant hypertension |
publisher |
Tehran University of Medical Sciences |
series |
Acta Medica Iranica |
issn |
0044-6025 1735-9694 |
publishDate |
2017-10-01 |
description |
A 47-year-old woman presented with a history of resistant arterial hypertension, associated with disabling headache. She was subjected to an enormous number of tests in order to identify an underlying cause of secondary hypertension, such as pheochromocytoma or Cushing syndrome, but all the most common causes of secondary hypertension were investigated and gradually excluded. Factitious use of amphetamine or cocaine was excluded, and therapy compliance was verified by witnessed ingestion of drug therapy, in order to rule out Munchausen syndrome. The patient underwent a first transcatheter renal denervation (RDN) with poor effect on blood pressure (BP) at long term follow up. Because of extremely poor control of BP values, a second RDN was performed two years later, again with inadequate long term efficacy. Despite an uncontrollable pre-procedural BP, RDN had an excessive BP lowering effect in this patient, but only for few months. In conclusion, a definitive diagnosis was not performed in our patient, despite an extremely deepened examination of the most common cause of refractory hypertension.
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topic |
Hypertension Refractory hypertension Renal denervation |
url |
https://acta.tums.ac.ir/index.php/acta/article/view/5444 |
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