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"Flash" pulmonary edema as a clinical manifestation of renovascular hypertension
Srpski arhiv za celokupno lekarstvo, 2003-05, Vol.131 (5-6), p.208-210
ISSN: 0370-8179 ;EISSN: 2406-0895 ;PMID: 14692125
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Title:
"Flash" pulmonary edema as a clinical manifestation of renovascular hypertension
Author:
Kalimonovska-Ostrić, Dimitra
;
Ivanović, Branislava
;
Ostrić, Vladimir
;
Knezivić, Vesna
;
Stojanov, Vesna
;
Simić, Dragan
Subjects:
Adult
;
Female
;
Humans
;
Hypertension, Renovascular - complications
;
Hypertension, Renovascular - diagnosis
;
Male
;
Middle Aged
;
Pulmonary Edema - etiology
;
Renal Artery Obstruction - complications
;
Renal Artery Obstruction - diagnosis
Is Part Of:
Srpski arhiv za celokupno lekarstvo, 2003-05, Vol.131 (5-6), p.208-210
Description:
One of the clinical manifestations of renovascular hypertension (RVH) may be a recurrent pulmonary oedema both in the absence or in the presence of systolic left ventricular dysfunction. This type of pulmonary oedema characterized as "flash" pulmonary oedema is ascribed to elevated angiotensin II concentrations with consequent hypertension as well as to volume overload resulting from decreased pressor natriuresis when there are significant stenoses of both or one renal arteries. The investigation included 30 patients with RVH treated by percutaneous transluminal angioplasty of the stenosed renal artery (PTRA) and/or stent implantation (PTR-ST) and 30 patients with surgical resection of the abdominal aortic aneurysm (AAA). The first group was divided in two subgroups according to the etiology of renal artery stenosis (RAS). In the subgroup with fibromuscular dysplasia (FMD) the mean age was 37.5 years, in the subgroup with atherosclerotic renal artery stenosis (ARAS) 54.8 years and in the group with operated AAA 68.6 years. There were more females than males only in the FMD subgroup (10:3). Two patients of the first group experienced pulmonary oedema, both in the subgroup with atherosclerotic renal artery stenosis associated with atherosclerosis of other arteries. Normalization of the blood pressure following PTRA in both and an uncomplicated course after a surgical myocardial revascularization in one of them illustrates the importance of renal revascularization. Pulmonary oedema occurred preoperatively in four out of 30 patients with abdominal aortic aneurysm in whom significant renal artery stenoses coexisted. Two patients died despite surgery, one patient is clinically stable and the medicament treatment of heart failure is inevitable in the fourth with a left ventricular aneurysm following myocardial infarction. The occurrence or recurrence of pulmonary oedema in the absence of other explanation should suggest the possibility of bilateral or unilateral renal artery stenosis requiring renal revascularization for blood pressure regulation as well as for elimination of other manifestations/complications.
Publisher:
Serbia
Language:
Serbian
Identifier:
ISSN: 0370-8179
EISSN: 2406-0895
PMID: 14692125
Source:
MEDLINE
DOAJ Directory of Open Access Journals
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