hrvatski

Renovaskularna hipertenzija: prikaz slučaja

Introduction: Renovascular hypertension is a condition in which high blood pressure is caused by the kidneys' hormonal response to narrowing of the arteries supplying the kidneys. Due to low local blood flow, the kidneys mistakenly increase blood pressure of the entire circulatory system. RVH is one type of secondary hypertension. Its most common causes are atherosclerotic renal artery stenosis and fibromuscular dysplasia. Case report: We report a case of a 38-year-old woman, who was admitted to the Department of Cardiovascular Diseases in November 2017 due to acute myocarditis, pulmonary edema and high blood pressure. She was subsequently hospitalized several times for hypertensive pulmonary edema. The last hospitalization was in September 2020 due to cardiac decompensation, unregulated arterial hypertension and deterioration of renal function. We suspected renovascular hypertension and CT angiography of renal arteries was performed. CT showed subocclusion of the right renal artery and subocclusion of the main left renal artery. The patient has physiological variation presented as two left renal arteries. Occlusion of the left iliac internal and external artery was also detected. Echocardiography showed an estimated 40- 45% ejection fraction, left atrial dilatation, mild mitral valve regurgitation and there were no signs of aortic coarctation. She was recommended for stenting left internal iliac and left main renal artery. Conclusion: RVH is an uncommon but potentially remediable cause of hypertension. We should suspect RVH in patients with hypertension that is difficult to control. CT angiography is indicated for diagnosis. Appropriate treatment continues to evolve, but control of hypertension is imperative.

renovaskularna hipertenzija, CT angiografija, plućni edem

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