[Recurrent hypertensive crises associated with severe orthostatic hypotension due to baroreflex failure syndrome].
The baroreflex mechanism is a central part of the regulation of the cardiovascular system, particularly in the control of vagal and sympathetic outflow to the heart and the peripheral circulation. Failure of the baroreflex is a rare cause of secondary hypertension. It is characterized by drastic changes in sympathetic activation and blood pressure following complete denervation of the baroreflex. Here, we report a case of baroreflex failure following bilateral carotid artery surgery and radiation. Moreover, postoperative orthostatic hypotension with recurrent syncope suggests a rare subform, the selective baroreflex failure, where efferent parasympathetic activity is preserved. Both high blood pressure and orthostatically induced syncope improved substantially after treatment with clonidine.
Frantz
S
S
Medizinische Universitätsklinik Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany. s.frantz@mail.uni.wuerzburg.de
Lührs
H
H
Allolio
B
B
Koller
M L
ML
D017704:Baroreflex / Q000502:physiology*; D002339:Carotid Arteries / Q000528:radiation effects / Q000601:surgery; D016893:Carotid Stenosis / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D016894:Endarterectomy, Carotid; D005260:Female; D006321:Heart / Q000294:innervation; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D007024:Hypotension, Orthostatic / Q000175:diagnosis* / Q000503:physiopathology; D007049:Iatrogenic Disease; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000503:physiopathology; D012021:Reflex, Abnormal / Q000502:physiology*; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014630:Vagus Nerve / Q000503:physiopathology