Hyperaldosteronism

Question 1

Hyperaldosteronism can be classified as…

Answer 1

Primary

Secondary

Question 2

Primary hyperaldosteronism is also known as…

Answer 2

Conn’s syndrome

Question 3

Describe the pathophysiology of primary hyperaldosteronism

What are the causes of this?

Answer 3

Pathology of the adrenal gland(s) resulting in production of excess aldosterone

Causes:

• Adrenal adenoma (most common)
• Bilateral adrenal hyperplasia
• Adrenal carcinoma (rare)

Question 4

Describe the pathophysiology of secondary hyperaldosteronism

What are the causes of this?

Answer 4

This is where excessive renin stimulates the adrenal glands to produce too much aldosterone

Causes:

• Renal artery stenosis/obstruction
• Heart failure

Question 5

Which blood test would allow you to differentiate between primary and secondary hyperaldosteronism?

Answer 5

Check the aldosterone: renin ratio:

• High aldosterone and low renin = primary hyperaldosteronism
• High aldosterone and high renin = secondary hyperaldosteronism

Question 6

Describe the medical management of hyperaldosteronism

Describe the interventional management of hyperaldosteronism caused by:

a) Adrenal adenoma
b) Renal artery stenosis

Answer 6

Medical:
- Aldosterone antagonists, e.g. eplerenone, spironolactone

Interventional:

• Surgical removal of adenoma
• Percutaneous renal artery angioplasty

Question 7

Hyperaldosteronism is the most common cause of secondary hypertension… True or false?

Answer 7

True

Question 8

Hyperaldosteronism is also known as…

Answer 8

Conn’s syndrome