Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Renovascular hypertension is common in nonspecific aortoarteritis (Takayasu disease). The utility of percutaneous transluminal renal angioplasty in managing this disease has been reported infrequently, and technical problems in using this treatment method have not been described. We retrospectively evaluated the results of renal angioplasty in treating 33 stenoses in 20 patients. Each patient's diagnosis was based on the criteria established by the Aortitis Syndrome Research Committee of Japan. Criteria for selection of patients for angioplasty were (1) severe hypertension uncontrolled by single-drug therapy, (2) angiographic evidence of at least 70% stenosis of the renal artery with a pressure gradient of more than 20 mm Hg, and (3) a normal sedimentation rate. The transfemoral route was used to treat all 33 stenoses. Follow-up examinations included blood pressure and medication evaluation 1 day, 1 week, and 4-6 weeks after treatment, and thereafter at 6-month intervals. Technical success was obtained in 28 lesions (85%) in 17 patients (85%). All failures occurred in the presence of coexistent abdominal aortic disease and tight, proximal stenosis of the renal artery. Technical difficulties were attributed to the tough, noncompliant nature of the stenoses, which were difficult to cross and resisted repeated, prolonged balloon inflations. These patients experienced backache and a fall in systemic blood pressure during balloon inflation. In one patient, the ipsilateral renal vein was injured during angioplasty and required surgery. Clinical success was obtained in 14 (82%) of the 17 patients in whom technical success was achieved and included cure in six patients and improvement in eight others. Follow-up 1-18 months (mean, 8 months) after treatment showed restenosis in six (21%) of 28 lesions. We conclude that renal angioplasty in nonspecific arteritis is associated with technical difficulties; however, the short-term results are good and the complication rate is acceptable.
 ...
PMID:Renal artery stenosis caused by nonspecific arteritis (Takayasu disease): results of treatment with percutaneous transluminal angioplasty. 134 73

We present a rare case of aortitis syndrome associated with dilatation of aorta and coarctation-like effect due to the intraluminal flap formation originated from dissected wall of the aorta. A 31-year-old woman was admitted to our hospital complaining of shortness of breath, palpitation and cough. On admission, her physical status showed congestive heart failure and hypertension of upper extremities and hypotension of lower extremities. Bruits were audible over the neck, the anterior chest and the back. Serological studies showed active inflammation. Chest X-ray film showed upper mediastinal widening, cardiomegaly and pulmonary edema. Aortitis syndrome was strongly suggested by these clinical findings, so that prednisolone therapy was started on 3rd hospital day. Special examinations were performed several days later when inflammatory changes showed a tendency to improve. Chest CT scan, RI angiography and MRI studies showed an aneurysmal dilatation from the ascending aorta to the mid-thoracic aorta. Aortography demonstrated a flap at the terminal portion of this aneurysmal dilatation and grade II (Sellars) aortic regurgitation. There was a pressure difference of 80 mmHg between the parts abutting cranial and caudal sides of the flap. A surgical operation was, then, performed to correct the pressure difference. The dissected wall was extruded toward the aortic lumen creating a flap (2 cm in length). This flap was resected and an artificial graft was inserted. Histologically, the flap consisted of adventitia, media and intima.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[A case of aortitis syndrome which presented coarctation of aorta due to intraluminal flap formation in the middle of the thoracic aorta]. 272 9

A case of aortitis syndrome associated with hypertensive intracranial hemorrhage is reported. A 38-year-old female was admitted in 1980 suffering from hypertension and blood pressure difference between the left and right arms which had existed for 10 years. Two weeks prior to admission, she noticed weakness and numbness of the right arm and leg. She was orientated and alert at the time of admission. Her right upper and lower extremities could not function with full strength against resistance. Also, right hemihypesthesia and hemiparesthesia were present. Left arm systolic blood pressure was 195 mmHg. Her pulse was palpable in both radial arteries. CT scans revealed a small high density area in the posterior crus of the internal capsule with a slight mass effect. There was no ventricular dilatation. She was given conservative treatment, such as with antihemorrhagic and antihypertensive drugs, and was discharged with good recovery after three months. Various studies were performed during her hospital stay. Based on angiographic findings, the most probable diagnosis was an extensive type of aortitis syndrome. Hypertension resulted from narrowing of the abdominal aorta and the right renal artery. Pulmonary scintiscanning using 99mTc-macroaggregated albumin revealed that her pulmonary arteries were also involved. Aortitis syndrome is not infrequent, but intracranial hemorrhage following after aortitis syndrome is rare. This may be because the carotid artery is involved in a high incidence of such cases, and therefore the intracranial blood flow is disturbed in most cases. Although the left common carotid artery was involved in the subject case, hypertensive intracranial hemorrhage occurred in the left posterior crus of the internal capsule. In a case of aortitis syndrome, therapy resulting in recirculation to the carotid artery involved is generally carried out in order to improve poor intracranial blood flow. However, it is suggested that control of blood pressure is necessary to prevent intracranial hemorrhage in aortitis syndrome.
 ...
PMID:[A case of aortitis syndrome associated with hypertensive intracranial hemorrhage (author's transl)]. 612 63

Aortitis syndrome named in Japan is widely known as Takayasu's arteritis internationally. Based on the experiences accumulated since the report of eyeground changes by Takayasu, it has become clear that the clinical manifestations of the disease are quite variable, including pulseless disease, atypical coarctation of the aorta, renovascular hypertension, aneurysms, aortic regurgitation and coronary artery disease. Pulmonary artery involvement is not infrequently present. For an exact diagnosis, it must be kept in mind that two or more of these manifestations are combined in most of the patients. The data of several epidemiological studies are presented and some of the recent literature reviewed.
 ...
PMID:Aortitis syndrome (Takayasu's arteritis). A historical perspective. 765 Aug 35

Dissection of aorta is a serious condition; the main factors are hypertension and diseases of the connective tissue or of collagen. Aortitis syndrome in combination with hypertension and atherosclerosis in association with ascending aortic dissection is rarely seen. We present the case of a 53-year-old hypertensive patient whose ascending aortic dissection was associated with pericardial effusion without rupture of the aorta and with pleural effusion. Several unusual aspects of transesophageal echocardiography are described. The intraoperative biopsy revealed inflammatory aortitis with mural hematoma, without giant cells. The literature concerning aortic dissection and aortitis is reviewed.
 ...
PMID:Stanford type A aortic dissection in a hypertensive patient with atherosclerosis of aorta and aortitis. 1097 79

A 21-year-old woman with a 6-year history of ulcerative colitis admitted to our hospital with chest pain, cough and fever of unknown origin in August 1998. On admission, laboratory data showed positive inflammatory signs. A chest radiograph and chest computed tomogram (CT) revealed nodular shadows in the right upper lung field. Fifty days after admission, hypertension developed and a bruit was audible in the neck and the upper abdomen. Digital subtraction angiography showed stenosis in carotid, renal and right upper pulmonary arteries. On the basis of these results, a diagnosis of aortitis syndrome was made. Moreover, these findings indicated pulmonary infarction in the right upper lobe due to aortitis syndrome. Aortitis syndrome preceded by pulmonary infarction involvement is very rare. Autoimmune disorders may have been involved in this case because of the association with ulcerative colitis.
 ...
PMID:[Aortitis syndrome associated with ulcerative colitis, preceded by pulmonary infarction involvement]. 1148 30

We report the surgical repair of a case of mid-aortic syndrome (MAS) in a 17-year-old female patient. She was initially diagnosed with renovascular hypertension at the age of 12 years. Aortitis syndrome was suspected, and she has been treated with antihypertensive drugs since then. Angiography revealed severe stenosis of the abdominal aorta and left renal artery and occlusion of the right renal artery and superior mesenteric artery (SMA); this confirmed the diagnosis of MAS. Due to progressive, uncontrollable hypertension, we performed an ascending aorta-abdominal aorta bypass with revascularization of SMA and both renal arteries. Her blood pressure normalized following the operation.
 ...
PMID:Ascending aorta-abdominal aorta bypass with the reconstruction of superior mesenteric and bilateral renal arteries for mid-aortic syndrome. 1723 57

A 58-year-old woman was admitted to our institute. Aortitis syndrome was diagnosed when she was 39 years old. She developed intractable hypertension several years prior, and a computed tomography (CT) scan showed severe calcified stenosis of the descending aorta. The ankle brachial pressure index of the right leg was 0.70 and that of the left leg was 0.63. Plasma renin activity was 4.8 ng/ml/h. Ascending aorta-abdominal aorta bypass grafting was scheduled. The operation was successfully performed under partial cardiopulmonary bypass to control arterial blood pressure. An implanted graft was 14 mm in diameter. The postoperative ankle brachial pressure index of the right leg was 1.07 and that of the left leg was 1.03. Postoperative plasma renin activity was 0.2 ng/ml/h, and three-dimensional CT revealed that the implanted graft was patent. Postoperatively, hypertension was well controlled without medication.
 ...
PMID:[Ascending aorta-abdominal aorta bypass for a patient with renal hypertension induced by aortitis syndrome; report of a case]. 2176 14

A 63-year-old woman was admitted to our hospital. Aortitis syndrome was diagnosed 12 years ago. She developed intractable hypertension and a computed tomography scan showed coarctation of descending aorta with severe calcificaiton. Her ankle brachial pressure index (ABI) was 0.74 on the right side and was 0.70 on the left side. She underwent a bypass operation with 14 mm-diameter prosthetic graft from ascending aorta to the infrarenal abdominal aorta without using cardiopulmonary bypass. Postoperatively, ABI was 1.22 on the right side and was 1.21 on the left side, and hypertension was well controlled.
 ...
PMID:[Ascending aorta-abdominal aorta bypass for atypical coarctation with intractable hypertension due to aortitis syndrome; report of a case]. 2474 37