Shankarrao Dekate Parag, Reddy Satyanarayana, Prasad Vsv, Boda Sudha, Saini Lokesh, Patil Prashant
Department of Pediatrics, PICU, Lotus Hospital for Women and Children, Lakdikapool, Hyderabad, Telangana, India.
Indian J Crit Care Med. 2019 Jul;23(7):339-341. doi: 10.5005/jp-journals-10071-23210.
Mid aortic syndrome is rare cause of hypertensive urgency in children with poor outcome if left untreated, high index of suspicion with prompt management is the key to survival with good outcome. A 12-year-old boy was presented with fever, puffiness of face, and breathing difficulty. Clinically, he had hypertension with differential pulsation and BP in upper and lower limbs. He had peak systolic gradient of 80 mm Hg between upper and lower limb. His echocardiography and CT angiography was suggestive of significant isolated 80% narrowing of abdominal aorta without involvement any other large vessels. Percutaneous balloon dilatation of aorta was done considering multiple parameters. Post procedure, there was significant improvement in BP and we could wean his multiple anti-hypertensive drugs to keep his blood pressures below 95 centile. His BP remained control with minimum upper and lower limb gradient on follow up of almost 1 year.
Dekate PS, Reddy S, Prasad VSV, Boda S, Saini L, Patil P. An Uncommon Cause of Hypertensive Urgency in Young Adolescent: Case Report. Indian J Crit Care Med 2019;23(7):339-341.
Mid aortic syndrome is most uncommon amongst them. With prompt diagnosis and proper selection of therapeutic options like balloon dilatation or surgical correction, it has good prognosis. Aortic narrowing because of different diseases is an uncommon cause of HT urgency in children.
中段主动脉综合征是儿童高血压急症的罕见病因,若不治疗,预后较差,高度怀疑并及时处理是获得良好预后生存的关键。一名12岁男孩出现发热、面部浮肿和呼吸困难。临床上,他患有高血压,上下肢搏动和血压存在差异。上下肢收缩压峰值压差为80 mmHg。他的超声心动图和CT血管造影显示腹主动脉明显孤立性狭窄80%,未累及其他大血管。考虑到多个参数,对主动脉进行了经皮球囊扩张术。术后,血压有显著改善,我们能够逐渐减少他的多种降压药物用量,使他的血压保持在第95百分位数以下。在近1年的随访中,他的血压保持稳定,上下肢压差最小。
德凯特PS,雷迪S,普拉萨德VSV,博达S,赛尼L,帕蒂尔P。青少年高血压急症的罕见病因:病例报告。《印度重症监护医学杂志》2019年;23(7):339 - 341。
中段主动脉综合征在其中最为罕见。通过及时诊断和正确选择治疗方案,如球囊扩张或手术矫正,预后良好。因不同疾病导致的主动脉狭窄是儿童高血压急症的罕见病因。