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Journals
Romanian Journal of Cardiology
Volume 32 (2022): Issue 2 (June 2022)
Open Access
The Never-Ending Story of Complicated Hypertension
Emma Weiss
Emma Weiss
,
Gabriel Sica
Gabriel Sica
,
Ana Maria Balahura
Ana Maria Balahura
,
Cristina Japie
Cristina Japie
,
Daniela Bartos
Daniela Bartos
,
Lucian Calmac
Lucian Calmac
,
Costin Minoiu
Costin Minoiu
,
Laurentiu Gulie
Laurentiu Gulie
and
Elisabeta Badila
Elisabeta Badila
| Aug 19, 2022
Romanian Journal of Cardiology
Volume 32 (2022): Issue 2 (June 2022)
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Article Category:
Case Report
Published Online:
Aug 19, 2022
Page range:
113 - 119
DOI:
https://doi.org/10.2478/rjc-2022-0015
Keywords
resistant hypertension
,
polyvascular disease
,
chronic renal disease
© 2022 Emma Weiss et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Figure 1
Chest X-ray upon admission showing an increased cardiothoracic index, with no signs of pulmonary congestion or pleural effusion.
Figure 2
Electrocardiogram upon admission showing bradycardic sinus rhythm at 45 bpm with a corrected QT by Bazett formula of 416 ms, with Cornell criteria for left ventricle hypertrophy, and negative T waves in the lateral territory – DI, aVL, V5, V6.
Figure 3
Echocardiography with normal sized left ventricle but severe concentric hypertrophy and normal systolic function. Tissue Doppler Imaging revealed subclinical longitudinal systolic dysfunction with reduced global longitudinal strain predominantly in the infero-lateral basal segments.
Figure 4
24h Blood pressure monitoring displaying a riser-type dipping pattern and average blood pressure of 196/92 mmHg with high systolic variability.
Figure 5
Peripheral angiography showing right renal artery 40% tubular stenosis in the proximal segment, with a homogeneously opaque (preserved) nephrogram. Left renal artery is not visible after nephrectomy.
Figure 6
Coronary angiography showing circumflex artery with extensive atherosclerosis without significant lesions permeable stent and calcified right coronary artery with ostial chronic total occlusion.