Abstract: PO1809
Hypertension in a Young Female: A Common but an Intriguing Anecdote
Session Information
- Hypertension and CVD: Clinical, Outcomes, and Trials
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1402 Hypertension and CVD: Clinical, Outcomes, and Trials
Authors
- Butt, Batool, Foundation University Medical College, Rawalpindi, punjab, Pakistan
- Sabir, Sohail, National University of Medical Sciences, Rawalpindi, punjab, Pakistan
Introduction
Renal artery stenosis accounts for about 1-10% of the 50 million people with hypertension worldwide.All major trials conducted so far on RAS found no benefit with renal artery stenting.Here we report a case of resistant hypertension in a young female who subsequently found to have bilateral renal artery stenosis and ultimately benefitted from unilateral stenting.
Case Description
A 35 yrs female , married,with no comorbids,presented with 03 months history of intermittent epsiodes of throbbing headache along with dizziness, palpitations, fatigue. Examination revealed BP - 160/100 with no postural drop,and regular pulse with no radio-radial,radio-femoral delays.. Her baseline investigations(including blood complete picture, LFTs,RFTs,urine routine examination,PT/PTTK were Normal. Hepatitis B and C serology were negative) USG abdomen showed right shrunken kidney with no renal artery flows on Doppler ultrasound . She was put on four different groups of anti hypertensives including a beta blocker,a calcium channel blocker ,thiazide diuretic and an angiotensin receptor blocker but her blood pressure did not settle .Further investigations revealed raised ESR but other tests including autoimmune screening,2DECHO all negative-CT aortogram revealed a non visualised shrunken right kidney with attenuated right renal artery and a vascular kink in proximal left renal artery. DTPA scan showed estimated GFR of 66.7ml/min with 97% contribution by left kidney and 3% contribution by right kidney. So based on renal imaging findings ,a final diagnosis of bilateral renal artery stenosis was made. Percutaneous transluminal angioplasty with stenting to proximal left renal artery was done. She was given dual antiplatelets along with a statin post operatively and advised monthly follow up. Currently she is normotensive without any anti hypertensive medicine.
Discussion
Distinct and new diagnostic and therapeutic innovations for RAS accessible but the best modality for a particular patient remains arduous.Though Renal artery stenting has shown propitious results in few patients but not to the degree many have expected. More RCTs should be contemplated to scrutinize the clinical predictors which will aid in identifying appropriate indications and subgroups of patients that will raise hope of maximum outcome of this intervention and evading gratuitous procedures that wiil not benefit the patient