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Evidences of abdominal aorta stenosis in case 1. (A) Two-dimensional and color Doppler echocardiographic image revealed the stenosis of the descending abdominal aorta (left) and turbulent flow through narrowed segment on color Doppler (right). (B) Peak velocity and peak pressure gradient were 5.1 m/s and 105 mmHg, respectively, on continuous wave Doppler echocardiographic image. (C) Angiography and (D) three-dimensional reconstructed image of computed tomography angiogram revealed a significant stenosis of the suprarenal abdominal aorta (black and white arrows).
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Arterial hypertension is the most common cardiovascular disease in older than middle-aged patients. Reported incidence of secondary hypertension in this age group is around 10%. To evaluate secondary hypertension, history taking and physical examination should be precise, which are usually not routinely performed in busy outpatient clinic. Here, we...
Contexts in source publication
Context 1
... for LVH was performed and showed increased left ven- tricular mass (134 g/m 2 ) and dilated left atrium (an- teroposterior diameter 45.3 mm). The results of the subcostal four-chamber view imaging of the abdominal aorta revealed small-caliber abdominal aorta ( Figure 1A) with marked flow acceleration (peak velocity =5.1 m/s) ( Figure 1B). At this point, the patient's blood pressure in the upper and lower extremities was measured. ...
Context 2
... for LVH was performed and showed increased left ven- tricular mass (134 g/m 2 ) and dilated left atrium (an- teroposterior diameter 45.3 mm). The results of the subcostal four-chamber view imaging of the abdominal aorta revealed small-caliber abdominal aorta ( Figure 1A) with marked flow acceleration (peak velocity =5.1 m/s) ( Figure 1B). At this point, the patient's blood pressure in the upper and lower extremities was measured. ...
Context 3
... stenosis after branching to left subclavian artery was suspected. Subsequent aortic angiogram ( Figure 1C) with aortic pres- sure measurement showed 88 mmHg systolic pressure gradient at the mid thoracic aorta. The pressure gradient of the aortic arch for both carotid arteries and renal artery was normal. ...
Citations
... It delays identifying the clinical features and subsequent diagnostic workup to identify secondary causes of RH. Hence, BP should be measured in both arms ( Table 2), and auscultation should be done for the carotid, renal, and heart sounds and murmurs [23]. It will aid in the early identification of secondary causes of RH, especially in young adults, and reduce the CVD risk ( Table 2). ...
... В последнее время ведущую роль играют эндоваскулярные вмешательства, особенно у лиц с высоким риском и несколькими сопутствующими заболеваниями [12][13][14][15]. ...
Артериальная гипертензия является наиболее распространенным сердечно-сосудистым заболеванием у пациентов пожилого возраста. Частота вторичной гипертензии в этой возрастной группе составляет 5–10%. Несмотря на значительные достижения в диагностике и лечении симптоматических артериальных гипертензий (особенно эндокринных и реноваскулярных), актуальным остается вопрос своевременной диагностики редких форм вторичных гипертензий, особенно если они имеют стертую клиническую картину и длительный анамнез заболевания, что снижает настороженность врачей в отношении этой патологии. В статье представлен клинический случай редкой формы вторичной артериальной гипертензии – стеноза супраренальной аорты («коралловая» аорта, coral reef aorta). Выраженные кальцинированные бляшки формируются в просвете аорты и могут вызывать значительный стеноз, который проявляется ишемией кишечника, почечной недостаточностью или артериальной гипертензией вследствие ишемии почек. Ранняя диагностика этого заболевания позволяет своевременно провести оперативное лечение, назначить эффективное медикаментозное лечение и, соответственно, кардинально улучшить прогноз для таких пациентов.
Arterial hypertension is the most common cardiovascular disease in elderly patients. The frequency of secondary hypertension in this age group is 5–10%. Despite significant advances in diagnosis and treatment of symptomatic arterial hypertension (especially endocrine and renovascular ones), the issue of timely diagnosis of rare forms of secondary hypertension remains relevant, especially if they have a blurred clinical picture and a long history of the disease reducing doctors’ awareness of this pathology. The article presents a clinical case of a rare form of secondary arterial hypertension – suprarenal aorta stenosis ("coral" aorta, coral reef aorta). Distinct calcified plaques are formed in aortic lumen which may cause significant stenosis manifesting as intestinal ischemia, renal failure, or arterial hypertension due to renal ischemia. Early diagnosis of this condition allows timely surgical treatment, prescription of effective medications, and therefore dramatically improves the prognosis in these patients.
... Organ and muscle malperfusion distal to the affected aorta can lead most commonly to lower extremity claudication, resistant hypertension, and abdominal pain [1,2]. It is classically identified during the first three decades of life and has been traditionally treated with open surgery [3][4][5][6]. The authors present a unique case of severe abdominal aortic stenosis in a 60-year-old female who presented with uncontrolled hypertension. ...
... Middle Aortic Syndrome is a rare clinical presentation with only case studies and case series reported in the literature [4,5,[7][8][9]. There is no characteristic presentation, but this syndrome can lead to severe hypertension, diminished or absent femoral pulses, lower extremity claudication, incongruent extremity pressure measurements, and audible arterial bruits. ...
Middle Aortic Syndrome is a rare vascular disorder consisting of narrowing or stenosis of the distal thoracic or abdominal aorta. It is described in the literature in the form of case studies and case series. The authors present an unusual case of Middle Aortic Syndrome attributed to Takayasu’s arteritis in a 60-year-old female who presented to the emergency department with uncontrolled hypertension. Traditional intervention involves open surgical bypass. This case study reviews the published literature on this rare syndrome and illustrates a successful alternative to open surgery through an endovascular approach.
... Any condition causing steno-occlusion of the aorta is included in this entity, such as coarctation of the aorta (COA), aortitis, or systemic diseases that may affect the blood vessels (4). Common clinical vignettes include audible bruits over the neck, chest, or abdomen, and difference in blood pressure between the upper and lower extremities (27). ...
Although the causes of hypertension are usually unknown, about 10% of the cases occur secondary to specific etiologies, which are often treatable. Common categories of secondary hypertension include renal parenchymal disease, renovascular stenosis, vascular and endocrinologic disorders. For diseases involving the renal parenchyma and adrenal glands, ultrasonography (US), computed tomography (CT) or magnetic resonance (MR) imaging is recommended. For renovascular stenosis and vascular disorders, Doppler US, conventional or noninvasive (CT or MR) angiography is an appropriate modality. Nuclear imaging can be useful in the differential diagnosis of endocrine causes. Radiologists should understand the role of each imaging modality and its typical findings in various causes of secondary hypertension. This article focuses on appropriate imaging approaches in accordance with the categorized etiologies leading to hypertension.
In the era of Government 3.0, local governments focus on establishing, maintaining, and strengthening relationships with citizens to fulfill “service government”; they thus engage in administration customization. This research aims to provide a structural understanding of local Government 3.0 through network and semantic analyses of Big Data gathered from the homepage of Gyeongsangbuk-do, North Gyeongsang Province in Korea, and Naver and Daum, major Korean portals. Results show that information and opinions about future policies, issues, and plans, and about the vision of provincial government, are dominant on the portals, while the Gyeongsangbuk-do homepage mainly plays a role for communicating public grievances and requests. The portal sites are more suitable places for giving information about and discussing technologies and urban policies than the homepage is. This study contributes to the analysis of Government 3.0 on a local level. In addition, it can be used as a reference and comparison by other countries or local governments and scholars interested in the issue.
