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Case Reports
. 2014 Oct 23:2014:bcr2014204555.
doi: 10.1136/bcr-2014-204555.

Endovascular treatment of a rare cause of secondary hypertension in an elderly woman

Davinder Chadha  1 , Susheel Malani  1 , Pradeep Hasija  1 , A J Naveen  1
Affiliations
Case Reports

Endovascular treatment of a rare cause of secondary hypertension in an elderly woman

Davinder Chadha et al. BMJ Case Rep. .

Abstract

A 70-year-old woman on four antihypertensive drugs including diuretics presented with accelerated hypertension and acute pulmonary oedema. She had a bounding brachial pulse with feeble femoral pulses. A 256 slice CT scan revealed the presence of severe diffuse thoracoabdominal atherosclerosis. Cardiac catheterisation revealed 125 mm Hg gradient across the atherosclerotic segment at the level of thoracic 10-11 vertebrae. A self-deploying stent was implanted in the thoracoabdominal segment reducing the gradient across the disease segment to 20 mm Hg with a significant improvement in the luminal diameter of the aorta. Her upper limb blood pressure normalised on two antihypertensive drugs 6 weeks later.

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Figures

Figure 1
Figure 1
Aortic angiogram showing diffuse narrowing of the thoracoabdominal aorta along with a discrete calcific lesion at the level of thoracic vertebrae 10–11.
Figure 2
Figure 2
Aortic pressure tracing shows a gradient of 125 mm Hg across the prestenotic and poststenotic segment of the thoracic aorta.
See this image and copyright information in PMC

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