COMPLEMENTARY ROLE OF DIAGNOSTIC IMAGING IN SEVERE RENOVASCULAR ARTERIAL HYPERTENSION IN YOUNG PATIENTS
Abstract:
Renal artery stenosis represents the most frequent cause of secondary arterial hypertension.
The atherosclerotic disease, which mainly affects all the proximal third of the main artery, is
encountered mostly in the elders. The fibromuscular dysplasia affects most of all the distal two-thirds
and the renal arteries branches and is met mostly in young women. The renovascular disease is an
important and most of the time unknown cause of renal insufficiency, refractory hypertension and global
cardiovascular mortality. As long as the severe renal artery disease can cause renal dysfunction, the
identification and the treatment of important renal artery stenoses can have major benefits on the state
of health. We present an interesting case that falls into this pathology encountered in our medical
practice. There are multiple particularities of the case: the appearance of a severe hypertension
(Systolic TA over 260mmHg, diastolic BP over 150mmHg) in a 19 year-old male patient, absence of
symptoms, renal arteries anomaly, concordances and discordances of the imagistic investigations, early
appearance of complications of the arterial hypertension, and of the left ventricular hypertrophy and left
ventricle diastolic dysfunction, respectively; the association at the hypertensive cardiopathy of the
ventricular septal defect of and the basal interventricular septal aneurysm.
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