Cardio Symposium Secondary Hypertension Flashcards
Conn’s Syndrome (primary hyperaldosteronism) Pathology
Excessive secretion of aldosterone of the adrenal gland
Conn’s Syndrome (primary hyperaldosteronism) Signs and Symptoms
Musclular weakness due to hypokalaemia, hypertension due to salt and water retention
Conn’s Syndrome (primary hyperaldosteronism) Tests
Function of the renin-angiotensin-aldosterone system.
→ CT scan to help localise the adenoma
Conn’s Syndrome (primary hyperaldosteronism) Treatment
Surgical removal
Spironoacetone (Potassium-sparing diuretic)
Renal artery stenosis Pathology
Stenosis of the renal artery may be caused by atherosclerotic plaques. It results in activation of the renin-angiotensin-aldosterone system
Renal artery stenosis Signs and Symptoms
Symptoms and signs of atherosclerosis e.g. bruit over affected artery
ACE inhibitors may reduce renal perfusion and precipitate renal failure
Renal artery stenosis Tests
Angiography
Renal artery stenosis Treatment
Angioplasty and stenting or surgery
Pre-eclampsia Pathology
Placental ischaemia results in release of agents that cause endothelial dysfunction.
Pre-eclampsia Signs and Symptoms
Hypertension proteinuria +/- oedema occurring after week 20 of pregnancy
Pre-eclampsia Tests
Liver function, renal function, platelet count and uric acid
Pre-eclampsia Treatment
Antihypertensives, magnesium.
May required urgent delivery
Phaeochromocytoma Pathology
Catecholamine secreting tumour often located in the adrenal medulla
Phaeochromocytoma Signs and Symptoms
Paroxysmal (episodic) hypertension, pallor, palpitations, anxiety and abdominal pain
Phaeochromocytoma Tests
24hr collection of urine to screen or elevated levels of catecholamine metabolites CT scan to help locate tumour.
Phaeochromocytoma Treatment
Treatment with alpha- and beta adrenoceptor antagonists.
Surgical removal
Cushing’s Syndrome Pathology
Inappropriate elevation of free corticosteroids e.g. by and adrenal tumour
Cushing’s Syndrome Signs and Symptoms
Moon face, acne, hirsutism, buffalo hump, centra obesity and striaeMoon face, acne, hirsutism, buffalo hump, centra obesity and striae
Cushing’s Syndrome Tests
Cortisol levels, urinary cortisol and dexamethasone suppression test CT scanning to help locate tumour.
Cushing’s Syndrome Treatment
Surgical removal
Coarctation of the aorta Pathology
Narrowing of the aorta most commonly where the ductus arteriosus joins aorta
Coarctation of the aorta Signs and Symptoms
Raised blood pressure in upper limbs.
Systolic mumur heard posteriorly.
Weak femoral pulses and delayed in comparison to the radial pulses
Coarctation of the aorta Tests
Notching of under surface of ribs due to collaterals
Coarctation of the aorta Treatment
Surgical correction
