title: Aortic coarctation suspected by Doppler echocardiography of renal arteries in hypertensive patients referred to a hospital outpatient hypertension clinic.
abstract: Coarctation of the aorta is the fourth most frequent form of congenital cardiovascular disease, which is diagnosed by the presence of higher blood pressures in the arms than in the legs. In this report we describe 3 cases of aortic coarctation, in which the correct diagnosis was suspected only months or years after the detection of hypertension, when a renal ultrasound examination was requested, despite the fact that the hallmarks of the disease were present at the physical examination in all patients. A marked reduction in renal flow velocities was suggestive of proximal aortic stenosis in all 3 cases. We conclude that the diagnosis of aortic coarctation, an uncommon but not so rare form of secondary hypertension, by renal ultrasonography rather than by a complete physical examination, reflects a commitment failure of physicians in everyday management of hypertension.
authors.affiliation: Institute of Cardiovascular Medicine, University of Milan, Milan, Italy. dhipertensione@libero.it
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Stefano
authors.initials: S
authors.lastname: Meani
authors.forename: Cristiana
authors.initials: C
authors.lastname: Valerio
authors.forename: Veronica
authors.initials: V
authors.lastname: Fusi
authors.forename: Eleonora
authors.initials: E
authors.lastname: Catini
authors.forename: Fabio
authors.initials: F
authors.lastname: Magrini
authors.forename: Alberto
authors.initials: A
authors.lastname: Zanchetti
mesh_terms: D000293:Adolescent; D000328:Adult; D001017:Aortic Coarctation / Q000150:complications / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D012077:Renal Artery / Q000000981:diagnostic imaging*