[Atresia of the aortic arch. A rare cause of asymmetrical arterial hypertension in adulthood].
METHODS
A 58-year-old man, previously resident in Russia, was known since the age of 18 years to have arterial hypertension of unknown cause in only the right arm. A single syncope was the only previous symptom. On examination the pressure was 230/110 mmHg in the right arm, 150/100 mmHg in the left one. The pulse in the right arm and neck was strong and heaving, that in the left arm and the legs much more weakly palpable.


METHODS
Electrocardiogram and echocardiogram showed left ventricular hypertrophy. The chest radiogram demonstrated rib notching. Digital subtraction angiography revealed aortic arch atresia just distal to the common carotid artery. No other cardiovascular abnormalities were found.


METHODS
The patient declined operative treatment. Cautious antihypertensive drug treatment with Atenolol (25 mg daily) reduced the pressure in the right arm to 180/90 mmHg.


CONCLUSIONS
This rare malformation of aortic arch atresia should be considered in the differential diagnosis of asymmetrical arterial hypertension in an adult.
Heinrich
U
U
Abteilung Angiologie, Herz-Kreislauf-Klinik Bevensen.
Bolte
J
J
Aschenberg
W
W
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D015901:Angiography, Digital Subtraction; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000000981:diagnostic imaging; D001262:Atenolol / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005858:Germany; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012426:Russia / Q000208:ethnology
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D001262:Atenolol
Atresie des Aortenbogens. Seltene Ursache der asymmetrischen arteriellen Hypertonie im Erwachsenenalter.